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Full text of "North Carolina Register v.10 no. 2 (4/17/1995)"

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NORTH CAROLINA 

REGISTER 



VOLUME 10 • ISSUE 2 • Pages 54 -190 
April 17, 1995 



IN THIS ISSUE 

Executive Orders 

Acupuncture Licensing Board 

Environment, Health, and Natural Resources 

Human Resources 

Justice 

Labor 

List of Rules Codified 

Medical Examiners 

Real Estate Commission 

RRC Objections 

Contested Case Decisions 



PUBLISHED BY 

The Office of Administrative Hearings 
Rules Division 
PO Drawer 27447 
Raleigh, NC 27611- 744 7 
Telephone (919) 733-2678 
Fax (919) 733-3462 



Bag ■*! § fp" ~i \j B» £ 5 
E a i; f u^' ^i: J vJ aoakj> 

APR 20 1995 

KATHRINE R EYERETT 
LAW LIBRARY 



This publication is printed on permanent, acid-free paper in compliance with G.S. 125-11.13 



INFORMATION ABOUT THE NORTH CAROLINA REGISTER AND ADMINISTRATIVE CODE 



NORTH CAROLINA REGISTER 

The North Carolina Register is published twice a month and 
contains information relating to agency, executive, legislative and 
ludicial actions required by or affecting Chapter 150B of the 
General Statutes. All proposed administrative rules and notices of 
public hearings filed under G.S. 150B-21.2 must be published in 
the Register. The Register will typically comprise approximately 
fifty pages per issue of legal text. 

State law requires that a copy of each issue be provided free of 
charge to each county in the state and to various state officials and 
institutions. 

The North Carolina Register is available by yearly subscription 
at a cost of one hundred and twenty dollars ($120.00) for 24 
issues. Individual issues may be purchased for ten dollars 
($10.00). 

Requests for subscription to the North Carolina Register should 
be directed to the Office of Administrative Hearings, PO Drawer 
27447, Raleigh, NC 27611-7447. 

ADOPTION, AMENDMENT, AND REPEAL OF RULES 

The following is a generalized statement of the procedures to be 
followed for an agency to adopt, amend, or repeal a rule. For the 
specific statutory authority, please consult Article 2A of Chapter 
150B of the General Statutes. 

Any agency intending to adopt, amend, or repeal a rule must 
first publish notice of the proposed action in the North Carolina 
Register. The notice must include the time and place of the public 
hearing (or instructions on how a member of the public may 
request a hearing); a statement of procedure for public comments; 
the text of the proposed rule or the statement of subject matter; the 
reason for the proposed action; a reference to the statutory 
authority for the action and the proposed effective date. 

Unless a specific statute provides otherwise, at least 15 days 
must elapse following publication of the notice in the North 
Carolina Register before the agency may conduct the public 
hearing and at least 30 days must elapse before the agency can take 
action on the proposed rule. An agency may not adopt a rule that 
differs substantially from the proposed form published as part of 
the public notice, until the adopted version has been published in 
the North Carolina Register for an additional 30 day comment 
period. 

When final action is taken, the promulgating agency must file the 
rule with the Rules Review Commission (RRC). After approval 
by RRC, the adopted rule is filed with the Office of Administrative 
Hearings (OAH). 

A rule or amended rule generally becomes effective 5 business 
days after the rule is filed with the Office of Administrative 
Hearings for publication in the North Carolina Administrative 
Code (NCAC). 

Proposed action on rules may be withdrawn by the promulgating 



agency at any time before final action is taken by the agency or 
before filing with OAH for publication in the NCAC. 

TEMPORARY RULES 

Under certain emergency conditions, agencies may issue 
temporary rules. Within 24 hours of submission to OAH, the 
Codifier of Rules must review the agency's written statement of 
findings of need for the temporary rule pursuant to the provisions 
in G.S. 150B-21.1. If the Codifier determines that the findings 
meet the criteria in G.S. 150B-21.1, the rule is entered into the 
NCAC. If the Codifier determines that the findings do not meet 
the criteria, the rule is returned to the agency. The agency may 
supplement its findings and resubmit the temporary rule for an 
additional review or the agency may respond that it will remain 
with its initial position. The Codifier, thereafter, will enter the 
rule into the NCAC. A temporary rule becomes effective either 
when the Codifier of Rules enters the rule in the Code or on the 
sixth business day after the agency resubmits the rule without 
change. The temporary rule is in effect for the period specified in 
the rule or 180 days, whichever is less. An agency adopting a 
temporary rule must begin rule-making procedures on the 
permanent rule at the same time the temporary rule is filed with 
the Codifier. 

NORTH CAROLINA ADMINISTRATIVE CODE 

The North Carolina Administrative Code (NCAC) is a 
compilation and index of the administrative rules of 25 state 
agencies and 40 occupational licensing boards. Compilation and 
publication of the NCAC is mandated by G.S. 150B-21.18. 

The Code is divided into Tides and Chapters. Each state agency 
is assigned a separate title which is further broken down by 
chapters. Title 21 is designated for occupational licensing boards. 
The NCAC is available in two formats. 

(1) Single pages may be obtained at a minimum cost of 
two dollars and 50 cents ($2.50) for 10 pages or less, 
plus fifteen cents ($0.15) per each additional page. 
Requests for pages of rules or volumes of the NCAC 
should be directed to the Office of Administrative 
Hearings. 

(2) The full publication and supplement service is printed 
and distributed by Barclays Law Publishers. It is 
available in hardcopy, CD-ROM and diskette format. 
For subscription information, call 1-800-888-3600. 

CITATION TO THE NORTH CAROLINA REGISTER 

The North Carolina Register is cited by volume, issue, page 
number and date. 10:01 NCR 1-67, April 3, 1995 refers to 
Volume 10, Issue 1, pages 1 through 67 of the North Carolina 
Register issued on April 3, 1995. 



t 



FOR INFORMATION CONTACT: Office of Administrative Hearings, ATTN: Rules Division, PO Drawer 27447, Raleigh, 
NC 27611-7447, (919) 733-2678, FAX (919) 733-3462. 



• 



NORTH CAROLINA 



IN THIS ISSUE 




I. EXECUTIVE ORDERS 

Executive Orders 73-74 . 



• 



Volume 1 O, Issue 2 
Pages 54 - 190 



April 17, 1995 



This issue contains documents officially 
filed through March 31, 1995. 



n. IN ADDITION 

NPDES Permit 

Wildlife Resources Commission Proclamation 



54- 55 



56 

57 



Office of Administrative Hearings 

Rules Division 

424 North Blount Street (27601) 

PO Drawer 27447 

Raleigh, NC 27611-7447 

(919) 733-2678 

FAX (919) 733-3462 



Julian Mann III, Director 

James R. Scarcella St., Deputy Director 

Molly Masich, Director of APA Services 

Ruby Creech, Publications Coordinator 

Teresa Kilpatrick, Editorial Assistant 

Jean Shirley, Editorial Assistant 



HI. PROPOSED RULES 

Environment, Health, and Natural Resources 

Sedimentation Control Commission 149 - 150 

Human Resources 

Medical Assistance 118- 122 

Medical Care Commission 58-118 

Mental Health, Developmental Disabilities and 

Substance Abuse Services 118 

Justice 

Departmental Rules 122 - 142 

Labor 

Job Listing Services Act 149 

Migrant Housing Act of NC 1 49 

Retaliatory Employment Discrimination Act 149 

Wage and Hour 142-149 

Licensing Boards 

Acupuncture Licensing Board 150- 151 

Medical Examiners 151 - 157 

Real Estate Commission 157 - 166 

IV. LIST OF RULES CODIFIED 167-169 

V. RRC OBJECTIONS 170 

VI. CONTESTED CASE DECISIONS 

Index to ALJ Decisions 171 - 175 

Text of Selected Decisions 

94 CPS 0237 176-178 

94 EDC 0533 179-184 

95 EHR 0140 185-186 

VH. CUMULATIVE INDEX 188-190 



♦ 



NORTH CAROLINA REGISTER 

Publication Schedule 

(November 1994 - September 1995) 



Volume 
and 
Issue 

Number 


Issue 
Date 


Last Day 

for 

Filing 


Last Day 
for Elec- 
tronic 
Filing 


Earliest 

Date for 

Public 

Hearing 

15 days 

from 

notice 


* End of 

Required 

Comment 

Period 

30 days 

from 

notice 


Last Day 

to Submit 

toRRC 


** Earliest 

Effective 

Date 


9:15 


11/01/94 


10/11/94 


10/18/94 


11/16/94 


12/01/94 


12/20/94 


02/01/95 


9:16 


11/15/94 


10/24/94 


10/31/94 


11/30/94 


12/15/94 


12/20/94 


02/01/95 


9:17 


12/01/94 


11/07/94 


11/15/94 


12/16/94 


01/03/95 


01/20/95 


03/01/95 


9:18 


12/15/94 


11/22/94 


12/01/94 


12/30/94 


01/17/95 


01/20/95 


03/01/95 


9:19 


01/03/95 


12/08/94 


12/15/94 


01/18/95 


02/02/95 


02/20/95 


04/01/95 


9:20 


01/17/95 


12/21/94 


12/30/94 


02/01/95 


02/16/95 


02/20/95 


04/01/95 


9:21 


02/01/95 


01/10/95 


01/18/95 


02/16/95 


03/03/95 


03/20/95 


05/01/95 


9:22 


02/15/95 


01/25/95 


02/01/95 


03/02/95 


03/17/95 


03/20/95 


05/01/95 


9:23 


03/01/95 


02/08/95 


02/15/95 


03/16/95 


03/31/95 


04/20/95 


06/01/95 


9:24 


03/15/95 


02/22/95 


03/01/95 


03/30/95 


04/17/95 


04/20/95 


06/01/95 


10:1 


04/03/95 


03/13/95 


03/20/95 


04/18/95 


05/03/95 


05/22/95 


07/01/95 


10:2 


04/17/95 


03/24/95 


03/31/95 


05/02/95 


05/17/95 


05/22/95 


07/01/95 


10:3 


05/01/95 


04/07/95 


04/17/95 


05/16/95 


05/31/95 


06/20/95 


08/01/95 


10:4 


05/15/95 


04/24/95 


05/01/95 


05/30/95 


06/14/95 


06/20/95 


08/01/95 


10:5 


06/01/95 


05/10/95 


05/17/95 


06/16/95 


07/03/95 


07/20/95 


09/01/95 


10:6 


06/15/95 


05/24/95 


06/01/95 


06/30/95 


07/17/95 


07/20/95 


09/01/95 


10:7 


07/03/95 


06/12/95 


06/19/95 


07/18/95 


08/02/95 


08/21/95 


10/01/95 


10:8 


07/14/95 


06/22/95 


06/29/95 


07/31/95 


08/14/95 


08/21/95 


10/01/95 


10:9 


08/01/95 


07/11/95 


07/18/95 


08/16/95 


08/31/95 


09/20/95 


11/01/95 


10:10 


08/15/95 


07/25/95 


08/01/95 


08/30/95 


09/14/95 


09/20/95 


11/01/95 


10:11 


09/01/95 


08/11/95 


08/18/95 


09/18/95 


10/02/95 


10/20/95 


12/01/95 


10:12 


09/15/95 


08/24/95 


08/31/95 


10/02/95 


10/16/95 


10/20/95 


12/01/95 



This table is published as a public service, and the computation of time periods are not to be deemed binding 
or controlling. Time is computed according to 26 NCAC 2B . 0103 and the Rules of Civil Procedure, Rule 6. 

* An agency must accept comments for at least 30 days after the proposed text is published or until the date 

of any public hearing, whichever is longer. See G.S. 150B-2 1.2(f) for adoption procedures. 

** The "Earliest Effective Date" is computed assuming that the agency follows the publication schedule above, 

that the Rules Review Commission approves the rule at the next calendar month meeting after submission, and 

that RRC delivers the rule to the Codifier of Rules five (5) business days before the 1st day of the next calendar 

month. 



Revised 10/94 



EXECUTIVE ORDERS 



EXECUTIVE ORDER NO. 73 

SUSPENSION OF RULES 

DURING LOCAL EMERGENCIES 

WHEREAS, electric service is one of the most essential 
services required by modern society, and the public welfare 
is immediately threatened by any occurrences, natural or 
manmade, which interrupt the delivery of electricity and 
electrical services; and 

WHEREAS, state and federal regulations prohibit electric 
supplier vehicles and commercial motor vehicle drivers from 
working extended hours to assist in the repair of damage 
and restoration of the delivery of electricity and electrical 
services; and 

WHEREAS, federal law, specifically 49 C.F.R. Section 
390.23, allows a Governor to suspend these rules and 
regulations if the Governor determines that an emergency 
condition exists. 

NOW, THEREFORE, by the authority vested in me as 
Governor by the laws and Constitution of the State of North 
Carolina, IT IS ORDERED: 

Section 1. 

Electric supplier vehicles and commercial motor vehicle 
drivers are exempt from the rules and regulations restricting 
their participation in emergency relief efforts during a "local 
emergency." A "local emergency" shall be considered to 
be any power outage or interruption of electric service that 
occurs within the State of North Carolina, including a near 
term threat or occurrence of a meteorological condition or 
other condition reasonably likely to result in power outages 
or electric service interruption. A "local emergency" begins 
when the affected electric supplier receives notice of the 
power outage or interruption of electric service or receives 
notice of the existence of conditions reasonably likely to 
result in power outages or electric service interruption. The 
"local emergency" continues until the necessary maintenance 
or repair work is completed and personnel utilized to 
perform necessary maintenance or repair work have returned 
to their respective normal work routines. 

This Executive Order is effective immediately. 

Done in the City of Raleigh this the 15th day of March, 
1995. 

EXECUTIVE ORDER NO. 74 

DESIGNATING THE YEAR OF THE 

MOUNTAINS AND CREATING THE YEAR 

OF THE MOUNTAINS COMMISSION 

WHEREAS, North Carolina's mountains are among the 
state's most valuable and unique assets; and 



WHEREAS, North Carolina's mountains merit widespread 
appreciation and understanding; and 

WHEREAS, growth and change have brought new sets of 
opportunities and challenges to people of the mountains; and 

WHEREAS, regional efforts and partnerships with the 
State are needed to address challenges facing mountain 
communities today and in the future; and 

WHEREAS, new initiatives for Western North Carolina 
can honor and share the culture and history of the mountains 
and enhance respect for the natural beauty and environment 
of the region while fostering quality growth and develop- 
ment; and 

WHEREAS, the people of North Carolina's mountains are 
pursuing a new vision for the mountains that integrates the 
needs of young people, education, technology, industry, and 
recreation while protecting the region's resources and 
quality of life; and 

WHEREAS, the people of North Carolina's mountains 
seek to enhance Regional Identity and Recognition, to 
cultivate Sustainable Communities, and to promote and 
support Mountain Stewardship. 

NOW, THEREFORE, by the power vested in me as 
Governor by the Constitution and laws of North Carolina, 
IT IS ORDERED: 

Section 1. Year of the Mountains. 

The Year of the Mountains is hereby designated July 1 , 
1995 through June 30, 1996. 

Section 2^ Establishment. 

The Year of the Mountains Commission is hereby estab- 
lished. 

Section 3. Membership and Terms. 

The Governor shall appoint 15 persons to serve on the 
Commission and shall designate one of its members to serve 
as Chair. The Commission shall meet regularly to carry out 
its duties at the call of the Chair. 

Section 4. Powers and Duties of the Commission. 

A. To develop a set of recommendations to effectuate 
the purposes of this Order through such activities 
as meetings, fact-finding tours, educational events, 
and reports. 

B. To focus statewide media and public attention on 
the mountains to enhance quality growth and 
development, protect the natural beauty, and 
preserve the culture of the region. 

C. To coordinate its efforts with local officials and to 
help promote mountain events. 

D. To perform and exercise such other duties and 



10:2 



NORTH CAROLINA REGISTER 



April 17, 1995 



54 



EXECUTIVE ORDERS 



powers as may be necessary to accomplish the 
purposes of this Executive Order. 

Section 5^. Administration. 

The Governor shall designate an Executive Coordinator to 
provide professional assistance and background information 
to the Commission, and coordinate its activities. The 
Executive Coordinator shall maintain the official minutes 
and other records of the Commission, and shall work in 
partnership with local and state governmental agencies, the 
community college and university system, and the private 
nonprofit sector to furnish additional staff assistance, 
educational and research materials, and any other adminis- 
trative support which the Commission may require. 

The Executive Coordinator shall report directly to the 
Commission and shall carry out its goals as set forth in the 
Commission's mission statement. Members of the Commis- 
sion shall receive necessary travel and subsistence expenses 
pursuant to N.C.G.S. 138-5. Funding for the Executive 
Coordinator and the Commission shall be provided by 
DEHNR, the Department of Commerce, the Department of 
Cultural Resources, and monies appropriated by the General 



Assembly. 

The Commission is authorized to accept donations of in- 
kind services and funds, subject to the Executive Budget 
Act. Western North Carolina Tomorrow (WNCT), a 
501(c)(3) nonprofit, has agreed to administer the funds, 
including those previously appropriated to it by the General 
Assembly. 

The Commission shall be considered a "public body" and 
its meetings shall be open to the public pursuant to General 
Statutes Chapter 143, Article 33C. The Commission, for 
administrative purposes only, shall be located in the 
Governor's Office. 

This Executive Order shall be effective immediately and 
expire June 30, 1996. 

Done in the Capital City of Raleigh, North Carolina, this 
the 27th day of March, 1995. 



< 



I 



i 



55 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



IN ADDITION 



STATE OF NORTH CAROLINA 

ENVIRONMENTAL MANAGEMENT COMMISSION 

POST OFFICE BOX 29535 

RALEIGH, NORTH CAROLINA 27626-0535 

PUBLIC NOTICE OF INTENT TO ISSUE STATE GENERAL NPDES PERMITS 

Public notice of intent to modify State National Pollutant Discharge Elimination System (NPDES) General Permits for Point 
Source Discharges of Stormwater associated with the application requirements and clarifications of the visual monitoring 
requirements in : 

NPDES No. NCGO 10000 governing the discharge of stormwater associated with construction activities including clearing, 
grading and excavation activities resulting in the disturbance land areas. 

On the basis of preliminary staff review and application of Article 21 of Chapter 143 of the General Statutes of North 
Carolina, Public Law 92-500 and other lawful standards and regulations, the North Carolina Environmental Management 
Commission proposes to modify State NPDES General Permits for the discharges as described above. 

INFORMATION: Copies of the draft NPDES General Permits and Fact Sheets concerning the draft Permits are available 
by writing or calling: 

Bill Mills 

Water Quality Section 

N.C. Division of Environmental Management 

P.O. Box 29535 

Raleigh, North Carolina 27626-0535 

Telephone (919) 733-5083 ext. 548 

Persons wishing to comment upon or object to the proposed determinations are invited to submit their comments in writing 
to the above address no later than May 26. 1995 . All comments received prior to that date will be considered in the final 
determination regarding permit issuance. A public meeting may be held where the Director of the Division of Environmental 
Management finds a significant degree of public interest in any proposed permit issuance. 

The draft Permits, Fact Sheets and other information are on file at the Division of Environmental Management, 512 N. 
Salisbury Street, Room 925-C, Archdale Building, Raleigh, North Carolina. They may be inspected during normal office 
hours. Copies of the information of file are available upon request and payment of the costs of reproduction. All such 
comments and requests regarding these matters should make reference to the draft Permit Number, NCG010000. 



Date: March 29, 1995 



A. Preston Howard, Jr., P.E., Director 
Division of Environmental Management 



10:2 NORTH CAROLINA REGISTER April 17, 1995 56 



IN ADDITION 



North Carolina Wildlife Resources Commission 



512 N. Salisbury Street, Raleigh, North Carolina 27604-1188, 919-733-3391 
Charles R. Fullwood, Executive Director 



PROCLAMATION 



Charles R. Fullwood, Executive Director, North Carolina Wildlife Resources Commission, acting pursuant to North 
Carolina General Statute §113-292 (cl) and authority duly delegated by the Wildlife Resources Commission, hereby declares 
that the season for harvesting striped bass by hook-and-line shall close in all waters of the Roanoke River Striped Bass 
Management Area downstream of the Edwards Ferry Boating Access Area at US 258 bridge on the Roanoke River in Halifax 
County at 12:00 midnight on Sunday April 9, 1995. 

In the Roanoke River and its tributaries upstream of the Edwards Ferry Boating Access Area at US 258 bridge 
striped bass may be harvested from 12:01 a.m. on Saturdays through 12:00 midnight on Sundays, and from 12:01 a.m. 
through 12:00 midnight on Wednesdays. On all other days all striped bass caught, regardless of condition, shall be 
immediately returned to the waters where taken and no striped bass may be possessed. 

The Roanoke River Striped Bass Management Area is defined as the inland and joint fishing waters of the Roanoke 
River and its tributaries, extending from its mouth to Roanoke Rapids Dam, including the Cashie, Middle, and Eastmost 
rivers and their tributaries. 

This proclamation shall be effective at 12:00 midnight on April 9, 1995 and shall remain in effect until a new 
proclamation closing described waters or portions thereof for striped bass fishing is issued. 

This proclamation supercedes and replaces all prior proclamations. 

NOTES: 

a) This Proclamation is issued under the authority of N.C.G.S. §§113-132; 113-134; 113-292; 113-304; and 
113-305. 

b) All striped bass regardless of condition caught during the closed season shall be immediately returned to 
the waters where taken and no striped bass may be possessed. 

c) Any person who violates this Proclamation also violates applicable law and is subject to the sanctions 
provided by law. 

NORTH CAROLINA WILDLIFE RESOURCES COMMISSION 



By: Charles R. Fullwood 

Executive Director 



Date: 4/3/95 



57 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



TITLE 10 - DEPARTMENT OF 
HUMAN RESOURCES 



Notice is hereby given in accordance with G.S. 
150B-21.2 that the NC Medical Care Commission 
intends to repeal rules cited as 10 NCAC 3H .0108 - .0109, 
.0206 -.0220, .0306- .0318, .0407 - .0409, .0505 - .0507, 
.0510 - .0517, .0605 - .0609, .0705 - .0712, .0810 - .0812, 
.0903 - .0911, .1003 - .1008, .1105 - .1109, .1130 - .1136, 
.1150 -.1163, .1204- .1208, .1210, .1306- .1308, .1405 

- .1406, .1408- .1410, .1501 - .1503, .1612 - .1613, .1703 

- .1704, . 1804 - . 1807; and adopt rules cited as 10 NCAC 
3H .2001, .2101 - .2110, .2201 - .2212, .2301 - .2308, 
.2401 - .2402, .2501 - .2506, .2601 - .2607, .2701, .2801 

- .2802, .2901 - .2902, .3001 - .3005, .3011 - .3016, .3021 

- .3032, .3101 - .3104, .3201 - .3202, .3301 - .3302, .3401 

- .3404. 

Proposed Effective Date: September 1, 1995. 

A Public Hearing will be conducted at 9:30 a. m. on June 
9, 1995 at the Council Building, Room 201, 701 Barbour 
Drive, Raleigh, NC. 

Reason for Proposed Action: To update state regulations 
for nursing homes to be compatible with federal regulations. 

Comment Procedures: In order to allow the Commission 
sufficient time to review and evaluate your written comments 
prior to the hearing, please submit your comments to Mr. 
Jackie Sheppard, APA Coordinator, DFS, P. O. Box 29530, 
Raleigh, NC 27626-0530, telephone (919) 733-2342 by May 
31, 1995, but in no case later than the hearing on June 9, 
1995. 

Fiscal Note: These Rules do not affect the expenditures or 
revenues of local government or state funds. 

CHAPTER 3 - DIVISION OF FACILITY 
SERVICES 

SUBCHAPTER 3H - RULES FOR THE 
LICENSING OF NURSING HOMES 

SECTION .0100 - GENERAL INFORMATION 

.0108 DEFINITIONS 

Th e following d e finitions will apply throughout this 

Subohaptor: 

~m "Abuse" moans the willful infliction of physical 

pain, injury, mental anguish or unreasonable 
confinem e nt whioh may oauoo or r e sult in t e mpo 
rnry or p e rman e nt mental or physioal injury, pain, 
harm, or death. — Abuse includes, but i s not limited 
to, the following! 

(ft) Verbal abuse — any us e of oral, written or gos 



-&- 



-(e)- 



-(d)- 



-(e)- 



-O)- 



-m- 



-w- 



-&- 



-m- 



■&- 



-(*>- 



-m- 



turod language whioh a reasonable person would 

view as disparaging and d e rogatory tormo to a 

pati e nt rogardlooo of his or her ago, ability to 

comprehend or disability; 

Sexual abu s e — sexual harassment, s exual coor 

oion or sexual assault of a pati e nt; 

Physioal abus e — hitting, clapping, kicking or 



corporal punishment of a patient; 

Mental abuse language or treatment which 



would b e vi e w e d by a reasonabl e person as 
involving humiliation, harassm e nt, threats of 
punishment or deprivation of a patient; 
— Unreasonable confinement — the separation of a 
patient from oth e r persons, or from hio or h e r 
room, against th e pati e nt's will or th e will of the 

patient's legal representative. Unreasonable 

confinement does not include emergency — e* 
short term monitor e d s e paration used as th e m 
poutio intervention to r e duo e agitation until a 
plan of care i s developed to moot the patient's 
needs. 
"Accident" moans an unplann e d or unwanted event 
resulting in th e injury or wounding, no matt e r how 
slight, of a patient or other individual. 
"Adequate" — moans, — when applied — to various 



s e rvioos, that the sorvioos ar e at least satisfactory 

in mooting a r e f e rr e d to need wh e n moaaured 

against contemporary professional standards of 

practice. 

"Administrator" m e ans the person who has author 

ity for and is r e sponsibl e for the ov e rall op e ration 

of a facility. 

"Appropriate" moans right for the specified use or 

purpose, suitabl e or prop e r wh e n used as an 

adj e ctiv e . — When us e d as a transitiv e v e rb it moans 

to sot aside for s ome specified exclusive u s e. 

"Brain injury long term care" is defined a s an 

interdisc i plinary, intensive maint e nanc e program 

for pati e nts who hav e incurr e d brain damag e 

caused by external physical trauma and who have 

completed — a primary — course of rehabilitative 

treatment and hav e r e aohod a point of no gain or 

progr e ss for more than thr ee consecut i v e months. 

Service s are provided through a medically supe r 

vised interdisciplinary process and are directed 

toward maintaining the individual at th e optimal 

l e v e l of physioal, oognitiv e and behavioral funo 

tion s . 

"Capacity" moans the maximum number of patient 

or resid e nt b e ds for whioh th e faoility is licensed 

to maintain at any giv e n tim e . — 

"Combination facility" moans a combination hom e 

as defined in G.S. 13 IE 101. 

Conval e scent care" — m e ans oaro givon for the 



purpos e of assisting th e patient or r e sid e nt to 
regain health or strength. 
-(40) "Department" means the North Carolina Depart 



10:2 



NORTH CAROLINA REGISTER 



April 17, 1995 



58 



PROPOSED RULES 



-W 



-tm- 



4U>- 



<m- 



-m- 



-m- 



■w- 



-(30)- 



-(3+)- 



-(33)- 



-(33)- 



mont of Human Resources. 

"Dir e otor of Nursing" rooano th e nuroe who hao 

authority and dir e ot r e oponoibility for all nursing 

services and nursing oare. 

"Drug" moana subotanooo; 



-(a) recognized in tho offioiol United Statoo Pharm a- 

oopo e ia, offioial National Formulary, or any 
supplement to any of thorn; 
(te) intended for uoo in tho diagnosis, euro, miti ga- 
tion, treatm e nt, or pr e v e ntion of diseas e in man 
or other animalo; 

(e) intended to affect tho structure or any function 

of tho body of man or other animals, i.e., 
subotanooo other than food; and 

(d) intended for uoo as a oomponont of any artiol e 

specified in (a), (b), or (c) of this Subparagraph. 

(13) "Duly licensed" moans holding a current and valid 

lioono e as requir e d und e r the G e n e ral Statutes of 

North Carolina. 

"Existing facility" — moans a facility currently 



licensed or a proposed facility, proposed addition 
to a lioonood — faoility or propos e d r e mod e l e d 
lioonood facility that — will be built aooording to 
plans and specifications which — have boon ap 
proved by tho Department through tho prolimi 
nary working drawings otato prior to th e e ff e otiv e 
date of thio Rule. 

(15) "Exit oonforonoo" moans tho conference hold at 

tho end of a survey, or investigation between tho 

D e partm e nt's — representativ e s — and th e faoility 

administration r e presentativ e . 

"Finding" moans a determination by tho Depart 

meet that an allegation of patient abuse or neglect, 

or misappropriation of pati e nt property has boon 

substantiated. 

"HIV Unit" moans designated areas dedicated to 

pationts or residents known to have Human Imn w- 

nod e fioionoy Virus dio e ao e . 

"Incid e nt" m e ans an unplanned or unwanted e v e nt 

which has not caused a wound or injury to any 

individual but whioh has tho potential for such 

should th e e v e nt bo repeated. 

"Int e rdisciplinary" m e ans an int e grated process 

involving a roprosontativo from each discipline of 

tho health care team. 

"Lio e nc e d praotioal nuro e " m e ans a nurs e who is 



duly lic e nc e d ao a praotioal nurs e und e r G.S. 90, 

Article 9A. 

"Licensee" moan s tho person, firm, partner s hip, 

aooooiation, corporation or organization to whom 

a lic e nse hao boon ioouod. 

"Medication" moans drug as defined in (11) of 



thio Rule. 

"Misappropriation of prop e rty" m e ans th e criminal 
taking, uoo, exploitation of, dootruotion of, or 
damage to, a patient' s bolonging s or money. — The 
Department must prove tho misappropriation of 
prop e rty by a pr e pond e ranc e of th e e vid e nc e . 



Conviction of tho criminal act is not a prerequisite 
to placing a finding conc e rning th e mioappropria 
tion of prop e rty on th e North Carolina Nurs e Aid e 
Registry. 

(2 4 ) "Nogloot" moans a failure through a lack of 

att e ntion, oarelooon e oo, or omission, to provid e 
tim e ly and oonoiotont o e rvio e o, tr e atm e nt or oare to 
a patient or patients whioh are nooooBary to obtain 
or maintain tho patient's of pationts' health, safety 
or oomfort. 

"N e w faoility" moans a proposed faoility, a pro 
po s ed addition to an existing facility or a proposed 
remodeled portion of an existing faoility that i s 
oonotruoted aooording to plans and specifications 
approved by th e D e partm e nt subs e qu e nt to th e 
effective date of this Rule. — If d e termined by tho 
Department that more than half of an existing 
faoility i s ro modeled, th e entire existing faoility 
shall b e consid e r e d a n e w faoility. 
"Nuroo Aide" moans any individual providing 



-(35)- 



-(36)- 



nursing or nuroing related service s to patients 
in a faoility who io not a lioonsed h e alth 
prof e ssional, a qualifi e d di e titian, or someon e 
who volunteers — to provide such services 
without pay, and listed in a nurse aide regis 
try approved by th e D e partm e nt. 
"Nuro e Aid e Trainee" moans an individual 



-&¥ 



who has not completed an approvod nurse 
aide training course and competency ovalua 
tion and is d e monstrating knowl e dg e , whil e 
p e rforming tanks for whioh th e y have boon 
found proficient by an instructor. — Those 
tasks shall bo performed under tho direct 
supervision of a r e gister e d nurs e . — Th e term 
do e o not apply to volunteers. 

(2 8 ) "Nursing Faoility" means that portion of a 

nursing homo certified under Title XIX of tho 
Social S e ourity Aot (M e dicaid) as in oompli 
anoo with f e d e ral program standardo for 
nuroing facilities. It io often used as s ynony 
rnous with tho term "nursing home" which i s 
th e usual pr e r e quisite lovol of state lioonsuro 
for nursing faoility (NF) o e rtifioation and 
Medicare — skilled — nursing — faoility — (SNF) 
certification. 

-(39) "Nurs e in oharg e " means th e nurs e to whom 

duti e s for a sp e cified numb e r of pati e nts and staff 
for a spec i fied period of time have boon delegated, 
such as for Unit A on tho 7 3 or 3 11 shift. 
"On duty" — moans personnel — who ar e awak e t 



-(30)- 



droooed, — responsive to patient needs and physi 

colly present in tho facility performing assigned 

duties. 

"Op e rator" m e ans the owner of tho nursing hom e 

busineoo. 

"Patient" moans any person admitted for nursing 



-(34)- 



-(33)- 



-(334- 



"P e reon" m e ans an individual, trust, e state, part 



59 



NORTH CAROLINA REGISTER 



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PROPOSED RULES 



norah i p of oorporation — including associations, 
joint steefc compani e s and inouranoo oompanieo. 

(34) "Propooal" m e ans a Negativ e Aotion Proposal 

containing dooumontation of findings that may 
ultimately bo classified ao violations and penalized 
accordingly. 

(35) "ProviBional Lio e noo" moans an amonded lioonoe 

recognizing significantly looo than full oomplianoo 
with the lioonsuro rules. 

(36) "Phyoioian" m e ano a p e rson licens e d und e r G.S. 

Chapter 90, Artiol e 1 to pmotio e m e dicine in North 
Carolina. 

(37) "Qualified Activit i es Director" moans a person 

who hao the authority and r e sponsibility for th e 
dir e otion of all thorapoutio aotivitioo in th e nursing 
fac i lity and who meets the qualifications sot forth 
under 10 NCAC 3H .120 4 . 

(3 8 ) "Qualified Di e titian" m e ano a p e rson who meets 

th e standards and qualification e otablioh e d by th e 
Commission on Dietetic Registration of the Amor 
icon Dietetic Association included in "Standard s of 
Praotio e " — o e v e n dollars and tw e nty fiv e o e nts 
($7.25) or "Cod e of Ethioo for th e Profession of 
Dietetic s " two dollars and fifteen oenta ($2.15), 



-m- 



I 



-(«)- 



-m- 



I 



American Dietetic A s sociation, 216 W. Jackson 

Blvd., Chioago, IL 60606 6995. 

"Qualifiod Pharmac i st" means a p e rson who io 



licensed to practice pharmacy in North Carolina 
and who moots the qualifications sot forth under 
10 NCAC 3H .0903. 

-(40) "Qualifi e d Social Sorvioes Director" — means a 

person who has the authority and responsibility for 
the provision of social sorvioes in the nursing 
hom e and who moots the qualification set forth 
und e r 10 NCAC 3H .1306. 

( 4 1) "Registered Nurse" moans a nurse who is duly 

licensed as a registered nurse under G.S. 90, 
Artiol e 9A. 



"R e sid e nt" means any person admitt e d for oar e to 
a domiciliary homo part of a combination homo 
as defined in G.S. 131E 101. 
"Sitt e r"m e ans an individual employed — te 



provide companionship and sooial interaction 
to a particular pationt, usually on a private 
duty basis. 



(44) "Supervisor in Charg e (domioiliary hom e )" 

m e ans any e mploy ee to whom sup e rvisory 
duties for the domiciliary homo portion of a 
combination homo have boon delegated by 
e ith e r th e Administrator or Dir e otor of Nurs 

( 4 5) Surveyor" moons an authorized representative of 

the Department who inspects nursing facilities and 
combination faciliti e s to determin e oompliano e 
with rulos ao s e t forth in G.S. 13 IE 117 and 
applicable state and federal laws, rules and regula 
l i on s . 



( 4 6) "Ventilator dependence" is defined as phyoiologi 

oal d e p e nd e ncy by a pati e nt on th e us e of a venti 
lator for mor e than e ight hours a day. 

( 4 7) "Violation" moans a finding which directly relates 

to a patient' s health, safety or welfare or which 
or e at e e a substantial risk that d e ath or s e rious 
physical harm will occur and is d e t e rmin e d to b e 
an infraction of the regulations, standard s and 
requirements sot forth in G.S. 13 IE 117 or appl i 
cabl e state and f e d e ral laws, rul e s and r e gulations. 

Authority G.S. 13 IE- 104; 42 U.S.C. 1396 r (a). 

.0109 EXEMPTIONS AND WAIVERS 

(a) Faciliti e s e x e mpt from rul e s for lio e nour e contained in 
this Subchapter are: 

(4-) facilities operated by the federal government; 

(2) faciliti es lioonood as a part of a ho s pital subj e ot 

to lio e nsur e under G.S. 13 IE, Artiol e 5, and 

G.S. 122C, Article 2, and 
(3) facilities operated by the State of North Caro 

(b) Waiv e rs of rul e s in this Subchapter are not authoriz e d 
by the Nursing Homo Lioonsuro Act. 

Statutory Authority G.S. 13 IE- 104. 

SECTION .0200 - LICENSURE 

.0206 LICENSE REQUIRED 

No p e rson defined in G.S. 13 IE 1(2) shall operate a 
nursing homo except as provided for in G.S. 13 IE 102. 
Those referenced statutes are adopted in accordance with 
G.S. 150B 14(o). 

Statutory Authority G.S. 131E-104; 150B- 14(c). 

.0207 APPLICATION REQUIRED 

(a) An application for lio e nour e shall bo submitted to the 
Department prior to a license being issued. 

(b) The Department shall bo notified in writing prior to 
th e ooourr e no e of any of th e following oiroumstanoos: 
(4-) final sit e o e l e otion, whioh must b e approv e d by 

the Department prior to con s truction; 



(3) construction of a now facility or any renovation 

of an e xisting fac i l i ty; 
(3) inor e ao e or d e cr e as e in b e d capacity for any 

level of caro; 
(4) the acquisition of a nursing homo or any change 

in own e rship including any change in a partner 

ship; or 
(5) change of name or location. 

Statutory Authority G.S. 13 IE- 104. 

.0208 CONTENTS OF APPLICATION 

The application shall contain the following; 



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April 17, 1995 



60 



PROPOSED RULES 



-(-!-) name and address of applicant; 

-(3) name and ourr e nt lioeno e number of tho Adminio 

trator; 

-(3) typo of facility to bo operated; 

-(4) location of tho facility; 

-(£) tho nam e and prinoipal buoinooo addr e oo of e aoh 

partner, if applicant io a partnorohip t 

-(6) tho namo and prinoipal business addrooo of oaoh 

and all officers and diroctoro as well as tho name 
and prinoipal bucin e oo addrooo of e aoh stockhold e r 
owning (dirootly or indirootly) T e n p e ro e nt or 
moro of tho stock; and 

-f?) such other documents or information as necessary 

to det e rmine complianc e with applicabl e rul e o and 
statutes as w e ll as tho magnitud e and oeope of 
services to bo offered. 



Statutory Authority G.S. 131E-104. 

.0209 ISSUANCE OF LICENSE 

Only one liconso shall bo issued to each facility. — The 
Departm e nt shall ioc . ua a lioonoo to tho operator of th e 
nursing hom e buoinooo upon v e rification of complianc e with 
applicable laws and rules. 

Statutory Authority G.S. 13 IE- 104. 

.0210 EXPIRATION 

Each license shall expire at midnight on tho expiration date 
of th e lio e ns e e xo e pt ao oth e rwioo provided in G.S. 150B 3. 

Statutory Authority G.S. 131E-104. 

.0211 RENEWAL 

Eaoh licens ee shall fil e an application for renewal of 
liconso with tho Department at least 30 day s prior to tho 
date of expiration on forms furnished by tho Department. 
Failure to fil e a r e n e wal application shall result in e xpiration 
of th e lio e ns e to op e rat e . 

Statutory Authority G.S. 13 IE- 104. 

.0212 TYPES OF LICENSE 

A liconso shall bo issued for a 12 month period; however, 
a provisional liconso may bo issued for a period of loss than 
12 months in eas e s wh e re th e facility has not fully compli e d 
with G.S. Chapter — 13 IE, Artiol e 6, Part A and rules 
contained in this Subchapter, and such noncompliance does 
not pose an immediate hazard to tho life or safety of tho 
persons oorvod. 

Statutory Authority G.S. 131E-104. 

.0213 POSTING OF LICENSE 

Th e lioenoo shall b e post e d in a promin e nt looation, 
accessible to public view, within tho licensed promises. 

Statutory Authority G.S. 13 IE- 104. 



.0214 EXCEEDING LICENSED CAPACITY 

(a) A lif e oare o e nter having an agroomonto to oar e for all 
residents regardless of level of care need s may temporarily 
increase bod capac i ty by ten percent or ton bods, whichever 
io loco, ov e r th e lic e ns e d b e d oapaoity for a p e riod up to 30 
days following notification of and approval by tho Depart 
mont, provided such increase is not aoeooiatod with a capital 
expenditure. 

— (b) A facility oth e r than a lif e oar e o e nt e r shall aooopt no 
mor e pati e nts than th e numb e r for which it io lio e nood in 
each level of care oxoopt in an emergency situation ap 
proved in advance and confirmed in writing by tho Deport 
m e nt. — Em e rg e ncy authorizations shall not oxoood seven 
calendar days and shall not oxoood th o total lio e no e d b e d 
capacity for tho facility. 

Statutory Authority G.S. 131E-104. 

.0215 TRANSFERABILITY 

licenses aro not transferable. — A licensee shall notify tho 
D e partm e nt in writing of any propoood chang e in own e rship 
at loast 30 days prior to th e e ff e ctiv e date of th e chang e . 
Tho now owner shall be responsible for submitting an 
application for license at loast 30 days prior to assuming 
own e rship. 

Statutory Authority G.S. 131E-104. 

.0216 DENIAL, AMENDMENT, OR REVOCATION 
OF LICENSE 

(a) Tho Department shall deny any licensure application 
upon becoming awaro that tho applicant is not in compliance 
with any applicabl e provision of the Certificate of Nood law 
locat e d in Artiol e 9 of Chapter 13 IE of th e G e n e ral Statutes 
and tho rule s adopted under that law. 

(b) Tho Department may amend a liconso by reducing it 
from a full lio e ns e to a provisional lio e ns e wh e n e v e r th e 
D e partment finds that: 

(4-) tho licensee has substantially failed to comply 

with tho provisions of Part A of Article 6 of 
Chapt e r 13 IE of th e G e n e ral Statut e s and th e 
rules promulgated under that Part; and 

(3) there is a reasonable probability that tho licensee 

can remedy tho licensure deficiencies withi a-ft 
reaoonabl e l e ngth of tim e ; and 

(3-) th e r e is a reasonable probability that tho lioonooo 

will bo able thereafter to remain in complia flee 
with tho nursing homo licensure rules for tho 
forooooablo future. 
The Departm e nt shall giv e th e license e written notic e of th e 
amondmont of his license. — This notice shall be given by 
registered or certified mail or by personal se r vice and shall 
oot forth th e r e asons for th e action. 

— (o) Th e provisional lic e nc e shall b e e ff e ctiv e imm e diat ely- 
upon its receipt by tho licensee and must be posted in a 
prominent looation, accessible to public view, within tho 
lic e ns e d premis e s in li e u of th e full lic e ns e . Th e provisional 



I 



61 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



license shall remain in offoct until; 
(i) th e D e partment rootoroo 



the lioonooo — to full 



lioonaur e otatuo; or 



(3) the Deportment revokes the liconfloo'a license; or 

(3) the end of the licensee's licensure year. 

If a lioonooo has a provisional lio e no e at the tim e that th e 
lioonooo oubmito a r e n e wal applioation, — the lio e no e , — if 
fonowod, shall also bo a provisional license unless the 
Department determine s that the licen s ee can bo returned to 
full lio e nour e otatuo. — A dooioion to iooue a provisional 
lioonoo is stay e d during the p e nd e noy of an administrativ e 
appeal and the licensee may continue to display ito full 
license during the appeal. 
— (d) The D e partment may r e vok e a lio e no e whenever: 

(4-) Th e D e partment findo that: 

(A) — the lioonooo has substantially failed to comply 

with the provisions of Parts A and B of Article 
6 of Chapt e r 13 IE of th e G e n e ral Statutes and 
the ruloo promulgated und e r thoo e parte; and 

(B) — it i s not reasonably probable that the licensee 

eon remedy the licensure deficiencies within a 
reas onable l e ngth of tim e ; or 
(3) Th e D e partment findo that: 



(A) — the licensee has substantially failed to comply 

with the provisions of Parts A and B of Article 
6 of Chapt e r 13 IE of the General Statu t e e; and 

(B) — although th e l i o o nooo may b e abl e to romody 

the deficiencies within a reasonable time, it is 
not reasonably probable that the licensee will 
be abl e to remain in oompliano e with nursing 
hom e lioenour e rul e s for th e fores ee abl e futur e ; 
er 

-(3) The Department finds that there has boon any 



(c) — The suspension will bo effectiv e when the notice i s 
s e rv e d or on th e date sp e cifi e d in th e notio e of ouop e noion, 
whichev e r io later. Th e s usp e nsion will r e main effective for 
the period specif i ed in the notice or until the facility 
demonstrates to the Department that conditions are no longer 
d e trim e ntal to th e h e alth and safety of th e patient. 

(d) Th e nursing hom e ohall not admit n e w patients during 
the effective period of the suspension. 

Statutory Authority G.S. 131E-104. 

.0218 PROCEDURE FOR APPEAL 

— A nursing homo may appeal any decision of the Depart 
m e nt to d e ny, revoke or alter a lioeno e or any decision to 
susp e nd admiooions by making ouoh an appeal in aooordane e 
with G.S. Chapter 150B and 10 NCAC IB .0200. 

Statutory Authority G.S. 13 IE- 104. 

.0219 INSPECTIONS 

(a) Any nursing homo licensed by the Department may bo 
insp e ct e d by any authoriz e d representative of the Depart 
m e nt at any time. Generally, inspections will b e conduct e d 
between the hours of 8 :00 a.m. and 6:00 p.m., Monday 
through Friday. However, complaint investigations shall be 
conducted at th e most appropriat e tim e for inv es tigating 
all e gations of th e oomplam fcr 

(b) At the time of inspection, any authorized roprooonta 
tivo of the Department shall make his presence known to the 
Administrator or oth e r p e rson in oharg e who ohall ooop e rate 
with th e roprooontativ e (s) and faoilitat e th e inspection. 

(c) Inspections of medical records will be carried out in 
accordance with G.S. 13 IE 105. 



failur e to oomply with th e provision s of Parts A (d) — Th e faoility Administrator shall provid e and mok e 



and B of Articl e 6 of Chapter — 13 IE of th e 
General Statutes and the rule s promulgated under 
those parts that endangers the health, safety or 
w e lfar e of th e pati e nts in th e facility. 



availabl e to repres e ntativ e s of th e D e partm e nt finanoial and 
statistical record s required to verify compliance with all 
rules contained in this Subchapter. 
— (e) — Th e D e partm e nt ohall mail a writt e n r e port of th e 



Th e issuanc e of a provisional lio e no e is not a proc e dural lio e nour e surv e y or complaint investigation whioh shall 



prerequisite to the revocation of a license pursuant to 
Subparagraphs (d)(1), (2) and (3) of this Rule. 

Statutory Authority G.S. 131E-104. 

.0217 SUSPENSION OF ADMISSIONS 

(a) — The Departm e nt may susp e nd th e admission of any 
new patient to any nursing hom e wh e n warranted under the 
provisions of G.S. 131E 109(c). 

(b) — The Department shall notify' the nursing home by 
o e rtifiod mail of th e d e cision to susp e nd admissions. — Suoh Statutory Authority G.S. 13 IE- 104. 
notioe will includ e : 

-(£) the period of the suspension; 



include statements of any deficiencies cited to the facility 
within 10 working days from the date of the licensu r e 
survey or oomplaint inv e stigation e xit conf e r e nc e . 

(f) The faoility Administrator ohall pr e par e a writt e n plan 
of correction and mail it to the Department within 10 
working days following receipt of any statement of dofioion 
oioo. Th e plan of correction ohall b e r e vi e w e d and acc e pt e d 
or r e j e ct e d with writt e n notio e giv e n to th e Administrator 
within 10 working days of receipt by the Department. 



-(3) factual allegations; 



.0220 



PUBLIC ACCESS TO DEPARTMENT 
LICENSURE RECORDS 



-(3) citation of statutes and rules alleged to b e vio 

lat e d; and 
-(4) notice of the facility's right to contested case 

hearing on the s uspension. 



(a) Exo e pt for documents containing th e information list e d 
in Paragraph (b) of this Rul e , Departm e nt fil e s pertaining to 
the licensure of any facility under this Subchapter shall bo 
open to inspection by any member of the public during 



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62 



PROPOSED RULES 



normal bu s iness hours, aftor the Department has had a 
roaoonablo opportunity to ensur e that none of th e informa 
tion id e ntifiod in Paragraph (b) will bo disclos e d during th e 
inspection. — Except for information identifiod in Paragraph 
(b), any member of the publio may obtain copies of any 
information oontain e d in the Departm e nt licensur e filoo, 
subject to th e following conditions: 

(1) Appropriate foots for the copying may bo charged 

in advance; and 

(3) Delivery of the oopioo may b e delay e d for a 

roaoonabl e time if th e D e partm e nt otaff io e n 
gaged in other duties at the time of the request, 
(b) Unless disclosure is ordorod by a court of competent 
jurisdiction, th e following olooo e o of information shall not b e 
disoloo e d to members of th e publio: 

(4) infonnati ea — about — the — diagnosis, — prognosis, 

treatment, — or any other confidential medical 
information undor G.S. 8 53, r e garding a nam e d 
person, unl e ss that p e rson cons e nts in writing to 
the disclosure; 
(3) the name of any per s on who provided inform a- 
tion concerning a faoility lio e nsod und e r this 
Subohaptor, or r e gister e d a oomplaint about th e 
treatment of a patient or resident, unless that 
person consents to th e di s clo s ure; 

(3) information identifying any p e rson as a r e cipi e nt 

of publio asoistanoo or social s e rvioos, unl e ss 
that person consents to the disclosure; and 

(4) any confidential communioation between the 

attorn e y for th e D e partm e nt and th e D e partm e nt. 
(o) Wh e n docum e nts in th e fil e contain only confid e ntial 
information of the typos identified in Paragraph (b), then 
they will bo removed from the file before inspection. — tf-a 
dooum e nt contains both information of thos e typ e s identifiod 
in Paragraph (b) and non confid e ntial information, th e n the 
Department will provide for inspection a copy of the 
document — from which the confidential — informati on — is 
dolotod, in li e u of th e original dooument. No ohargo will bo 
made for this copying if the person insp e cting the fil e s does 
not wish to retain the copies made. 

Statutory Authority G.S. 8-53; 108A-80; 13 IE- 104; 
131E-124(c); 132-1.1. 



writton agroomont or in a facility's governing bylaw sr 

—(e) The Administrator shall b e r e sponsible for the 

op e ration of a faoility and all s e rvioes offered and for 
compliance with all applicable state and federal laws and 
regulations. 

Statutory Authority G.S. 90-284; 131E-104. 

.0307 VACANCY IN ADMINISTRATOR 
POSITION 

(a) If th e position of Administrator booomoo vacant, the 
Department shall bo notified by the owner, licensee, or 
Chairman of the Board of the nursing homo on the first 
working day following suoh vaoanoy. — Th e notio e of a 
vaoanoy shall oontain th e name and lio e ns e number of the 
replacement or tho name of the person responsible for 
operation of the facility during the absonoo of a lioensod 
Administrator. 

—(b) — A vaoanoy in th e Administrator's position shall bo 
reviewed by tho Department every 30 days for licensure 
action. 

Statutory Authority G.S. 131E-104. 

.0308 NUMBER OF FACILITIES SERVED 

If an Administrator servos two or more faciliti e s locat e d 
51 or more miles apart or having a combin e d b e d oapaoity 
of moro than 130 bods, each faoility must have on Assistant 
Administrator who is duly lioensod and has writton authority 

to aot in th e Administrator's absenc e . Th e Assistant 

Administrator shall not servo as th e Dir e otor of Nursing. 

Statutory Authority G.S. 131E-104. 

.0309 FISCAL MANAGEMENT 

Tho Administrator of a facility shall establish and maintain 
records relative to operating costs and statistical records of 
th e op e ration of th e faoility whioh provid e a viable audit 
trail. — Those rooords shall includ e , but not b e limited to, 
detailed information indicating tho tim e worked by and 
salary paid to all employees, food invoices, and daily census 

information, including admissions and d i scharg e e. AH 

r e oords shall b e maintain e d for at l e ast two y e ars. 



SECTION .0300 - GENERAL STANDARDS OF 
ADMINISTRATION 

.0306 LICENSED ADMINISTRATOR 

— (a) — Each facility shall bo under tho direct management 
oontrol of one poroon who io ourrently lic e ns e d by th e North 
Carolina Stat e Board of Examin e rs for Nursing Hom e 
Administrators in accordance with G.S. 90, Article 20. — An 
Administrator so licensed shall not bo subject to domiciliary 
hom e or other faoility Administrator lioonsure r e quirem e nts 
e stablished by any othor agonoy. — Th e Administrator shall 
not sorvo simultaneously as tho Director of Nursing. 

(b) If an Administrator is not tho solo owner of a facility, 
hio authority and responsibility shall be oloarly d e fin e d in a 



Statutory Authority G.S. 131E-104. 

.0310 STATISTICAL DATA FOR STATE USE 

The Admini s trator of a facility shall maintain and make 
available to tho Department such statistical data as required 
by statute or rul e s oontain e d in this Subohaptor, for tho 
state's medical faciliti e s plan and/or proper review for 
certificate of nood determination. 

Statutory Authority G.S. 13 IE- 104. 

.0311 ADMISSIONS 

(a) No patient shall bo admitted except under tho orders 
of a duly lioensod physioian. 



63 



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10:2 



PROPOSED RULES 



(b) Tho Administrator ohall assure ? tuberculosis and other 
oommunioabl e diooaoo oor ee ning on admiooion and tuborou 



The facility Adminiotrator shall assure written policies and 
procedures whioh aro availabl e to and impl e m e nted by staff. 



looio ooreening annually thereafter until final dioohargo. Those polioi e o and proo e dur e o ohall oov e r at l e ast the 



Identification of a communicable disease does not, in all 
cases, in and of itself, preclude admission to the facility. 
The faoility ohall provide appropriate oar e and tr e atm e nt. 
—(e) — Tho faoility ohall aoquir e prior to or at th e time of 
admission ordors from the attending physician for the 
immediate care of tho patient or resident. 
—(d) — Within 4 8 houro of admission, th e faoility shall 
aoquir e modioal information whioh shall includ e ourr e nt 
medical — findings, — diagnosis, — rehabilitation — potential, — a 
summary of tho hospital stay if the patient is being trans 
f e rr e d from a hospital, and ord e ro for th e ongoing oar e of 
th e pati e nt. 

(o) If a patient is admitted from s omewhere other than a 
hospital, a phy s ical examination shall be performed either 
within 5 days prior to admiooion or within 48 houro follow 
ing admiooion. 

—(f) — Now facilitie s must prepare a plan of admission 
which, at a minimum, assures available staff time and plans 
for individual patient aooooomont, initiation of health oare or 
nuroing oar e piano, and impl e m e ntat i on of physioian and 
nursing treatment plans. — This plan must bo available for 
inspection during tho initial licen s ure s urvey prior to 
ioouanoo of a lio e no e . 

— (g) — Only p e rsons who are 1 8 years of age or old e r ohall 
bo admitted to tho domiciliary home portion of a combine 
tion faoility. 

Statutory Authority G.S. 13 IE- 104. 

.0312 PATIENTS AND RESIDENTS NOT TO BE 
ADMITTED 

Pationto or residents who r e quir e h e alth, habilitativ e , or 
rehabilitative care o r training beyond those for whioh tho 
facility is licensed and i s capable of providing s hall not bo 
admitt e d. 



Statutory Authority G.S. 131E-104. 

.0313 DISCHARGE OF PATENTS 

A record shall b e maintain e d of all d i scharges of patients 



following areas: 

— (4) admissions; 

— (2) di e tary; 

— (3) dischargee with physioian ord e rs and/or pati e nts or 

residents leaving against physician advice; 

— (4) gratuities and solicitation whioh at a minimum 

shall — provid e that no own e r, op e rator, ag e nt or 
e mploy ee of a — faoility nor any m e mb e r of his 
family shall accept a gratuity directly or indirectly 
from any patient or resident in tho facility or 
s olioit for any typ e of contribution; 
houookooping; 









infection control which mu s t include, but is not 



limited — to, requirements for sterile and aseptic 
toohniquoo; universal and isolation pr e cautions and 
oommunioable diooaoo ooreening i noluding annual 
tuberculosis screening for all s taff and inpatients 
of tho facility; 



-(7) maintenance of pati e nt m e dioal or h e alth oar e 



r e words inoluding charting or r e oord k ee ping; 
orientation of all facility personnel; 



patient or resident care plana, treatment and other 
h e alth oar e or nursing oar e , inoluding but not 
limited to all polioieo and prooedur e o r e quired by 
rules contained in this Subchapter; 
pationto' or re s idents' rights; 



■im- 

(11) physical evaluation for r e sid e nts and pati e nts at 

l e ast annually; 
(12) physician services and utilization of tho individ 

uol'fl private physician; 
(13) procur e m e nt of suppl ie s and e quipmont to moot 

individual pati e nt oare uoodo; 
(1 4 ) protection of pationto from abuse and neglect; 

range of services provided; 



-(45)- 

(16) r e cording and reporting to tho Department of 

accidents or incidents ooourring to pationto in any 
part of tho facility and maintenance of such ro 
ports or records; 

(17) rehabilitat i on s e rvic es ; 



(1 8 ) r e l e as e of m e dioal reoord informati efit 



indicating tho reasons for discharge, the physician's order (19) screening and reporting oommunioable disease to 



for or other authorization for discharge, and tho condition 
of th e pati e nt at th e time of discharg e . 

A patient known to hav e Human Immunod e fic ie ncy Virus (20) 
disease may not bo discharged solely on tho basi s of tho 
diagnosis of Human Immunodeficiency Virus disease except 
ao authoriz e d by th e provisiono of N.C. G e n e ral Statut e 
131E 117 (15) or other provioiono of th e N.C. G e n e ral 
Statutes or regulations promulgated thereunder or provisions 
of applicable federal law s and regulations. 

Statutory Authority G.S. 13 IE- 104. 

.0314 POLICES AND PROCEDURES 



tho Department (Divi s ion of Health Service s ) and 
local h e alth D e partm e nt; 

transf e rs. 



Statutory Authority G.S. 13 IE- 104. 

.0315 NURSING HOME PATIENT RIGHTS 

(a) — Written policies and procedures s hall bo developed 
and enforced to implement requirements in G.S. 13 IE 115 
et ooq. (Nuroing Hom e Pati e nts' Bill of Righto) concerning 
th e righto of pati e nts. — Th e Adminiotrator ohall mak e th e s e 
policie s and procedure s known to staff, patients and families 
of patients and shall ensure their - availability to tho public by 



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64 



PROPOSED RULES 



placing thorn in a conspicuous plaoo, 

(b) In matt e rs of patient abuo e , n e gleot or misappropria ^ 
tion the definitions oball hav e th e moaning d e fin e d in Rul e 
.010 8 of this Subchapter. 

Authority G.S. 131E-104; 131E-111; 131E-124; 131E-129; 
42 U.S.C. 1396 r (e)(2)(B). 

.0316 SAFETY AND ENVIRONMENTAL 
CONTROL 

(a) A lio e ns e d facility shall hav e polioi e s and proo e dur e s 
for pationt safety and for environmental control which at a 
minimum shall include infection control. 

(b) A facility with a lic e ns e d oapaoity of 51 b e ds or mor e 
shall have a safety and e nvironm e ntal control committee 
which includes repre s entation from administration; medical 
and nursing staff; pharmacy; maintenance, engineering or 
housekeeping; and di e tary Borviooo, 

(o) A faoility with a lio e ns e d oapaoity of 50 b e ds or l e ss 
shall have a safety and environmental control committee 
which at a minimum includes the Administrator and Diroc 
tor of Nursing, 
(d) All oommitte e m e mb e rs shall b e designated in writing. 
(o) Responsibilities and duties of any safety and environ 
mental committee shall include, but not bo limited to, the 
following: 

(4-) moot at least quarterly, maintain minutes inouffi 

ciorjt detail to document committee proceedings 
and actions, and submit reports to the Adminis 
trator; 

(3} e stablish an inoident — and aooidont — r e porting 

system in accordance with facility policies which 
includos a mechanism for reviewing, invoatigat 
ing and e valuating all incid e nts and accid e nts 
r e port e d. — The oommitt ee shall dooum e nt all 
reviews and action(s) taken; 

(£) conduct hazard surveillance program ;- 

(4} oonduot fir e proteotion program whioh inolud e s: 

(A) — developm e nt and adoption of a comprehensive 

fire and disaster plan; 

(£) — instruction and fire drills for all employees in 

th e following: 

(+) use of all alarms and signals; 

(») methods of fire containment; 

fiw) location and use of — fire fighting equip 

mont; 

(iv4 wh e r e , when and how to shut off oxyg e n 

and air conditioni ng*- 

fv) evacuation routes and procedures; and 

(vi} transmission of an alarm to th e fir e D e 

partro e nt or oth e r r e sponsibl e e m e rg e noy 
services; 
— assignment of specific responsibilities and tasks 
to all personn e l in respons e to an alarm; and a 
fir e drill for e aoh shift of omployooo at least 
quarterly; 
conduct water temperature surveillance program 
whioh assures oompliano e with Rul e .1 8 07(d) of 



this Subchapter; 
-(6) annually r e vi e w polioieo and proo e dur e c for 

inf e ction and communicable diooaoo oontrol; 
(A) handling food; 



-(€> 



-(B) — processing laundry; 
-(G)- 



-0*- 



disposing of e nvironmental or other waatoo and 
pationt or r e oident ourgioal or wound dreoo 
ings, porsonal care pads or other wastes; 

(-B) — controlling poets and reporting infectiono and 

dis e as e s; 

f£) monitor ov e rall e nvironm e ntal/inf e otion oontrol 

and implementation of safety policies and prooo 

(&) monitor — staff d e v e lopment — te — assure — active 

ongoing insorvio e — training at l e ast annually 
which shall include universal precautions and 
other areas of safety and environmental/infection 
oontrol for all personnel; and 

(9) aoting on r e quir e m e nts from th e Occupational 

Safety and Health Administratio &r 

Statutory Authority G.S. 13 IE- 104. 

.0317 REPORTING AND INVESTIGATING ABUSE, 
NEGLECT OR MISAPPROPRIATION 

(a) Th e faoility shall tak e r e asonabl e m e aour e c to pr e v e nt 
pati e nt abus e , pati e nt n e gl e ot, or misappropriation of pati e nt 
property, including but not limited to orientation and 
instruction of facility staff on patients' righto, and the 
r e questing of referenoeo for all prospootivo employees. 

(b) Th e Administrator shall aocuro that the Department is 
notified of all alleged incidents which appear to a reasonable 
person to bo related to pationt abuse, neglect or misappro - 
priation of pati e nt prop e rty. — 

(o) — Th e inoid e nt r e port s hall b e print e d or typ e d and 
postmarked within 48 hours of the alleged inoident. The 
report shall be conducted as specified in 42 CFR subsection 
4 8 3.13 and shall consist of a simpl e statement of the 
pati e nt's full nam e ; room numb e r; typ e of injury, date and 
time of the alleged incident of abuse, neglect or misappro 
priation of property; names of persons involved; and 
imm e diat e aotion tak e n by th e faoility. 

(d) Th e faoility shall thoroughly inv e stigat e and dooum e nt 
according to 4 2 CFR subsection 48 3.13, whioh is incorpo 
rated by reference, including subsequent amendments, all 
all e g e d incid e nts whioh app e ar to a r e asonable person to be 
inoid e nts of pationt abuo e , pati e nt negl e ot, or misappropria 
tion of pationt property and 3hall take whatever steps are 
necessary to prevent further incidents of abuse, neglect or 
misappropriation of prop e rty whil e th e inv e stigation io in 
progress. 

Authority G.S. 131E-104; 131E-111; 143B-165; 42 U.S.C. 
1395; 42 U.S.C. 1396; 42 C.F.R. 483. 

.0318 PERSONNEL STANDARDS 

(a) The Administrator shall provide for the following; 
(4-) numbers and typ e o of qualified personnel and 



65 



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April 17, 1995 



10:2 



PROPOSED RULES 



ancil l ary — services as necessary — to assure the 
health, oafoty and proper oare of pationto and 
rooid e nto; 

(3) on duty personnel who for health or other rea 

sons present no throat to the health and safety of 
pationto and rooidento; and 

(3) an individual p e rsonn e l rooord for e aoh e m 

ployoo rogardlooo of job assignm ent Such 

rooord shall bo kept current and shall include 
oortifioate and lic e nsure numb e rs, when applioa 
bio; the original application with v e rification of 
credentials; periodic performance ovaluationo; 
and a signed and dated certification that the 
employee hao road and understood th e facility' s 
polioioo governing conditiono of e mploym e nt, 
including but not limited to on duty dross, 
personal hygiene, sleeping on duty, ingestion of 
alcohol or oth e r drugs, oonduot towards pati e nts 
and rooidento, and th e w e aring of id e ntification 

(b) Each employee shall bo assigned duties consistent with 
hio job description and with hio level of e ducation and 
training, which includes docum e nted on the job training and 
experience and in service education. 

Statutory Authority G.S. 131E-104. 

SECTION .0400 - PATIENT OR RESIDENT CARE 
ASSESSMENT AND PLANNING 



.0407 GENERAL 

The Admini s trator shall assure that policies and procedures 
are available and implemented for assess i ng each patient's 
or r e sid e nt's h e alth oar e noedo and planning for meeting 
identifi e d health oare needs. Ther e shall b e a oyot e m for 
evaluating the effectiveness of the assessment, planning and 
implementation (delivery of care processes) for each patient 
or resid e nt. 



Statutory Authority G.S. 131E-104. 

.0408 FREQUENCY, METHOD AND CONTENT 
OF ASSESSMENT AND PLANNING 

Each patient's and re s ident's condition must bo assessed 

on a regular, periodic basis, at least quarterly, with appro 

priato notation and updating of th e h e alth oar e plan. — Heakb 

oare planning for eaoh pati e nt and resident shall bo an 

on going proce ss and must include but may not bo limited 

to the following! 

(1) data whioh is syst e matically and continuously 

ooll e ot e d about h e alth status; — Th e data shall b e 

recorded so as to be accessible and communicated 

to all s taff involved in the patient's o r resident 



8 






-m- 



ourront probl e ms and n ee ds id e ntifi e d and priori 
tizod from a completed assessment relevant to the 
patient' s or resident's response to aging, illnes s 



and his/her general health status; and 

— (3) a ourr e nt plan of oar e d e v e lop e d in conjunction 

with th e pati e nt or r e sid e nt and/or l e gal guardian 
that includes measurable time related goals and 
approaches, — or measures — to bo employed -by 
various disciplines in order to aohi e v e th e idonti 
fi e d goals. 

Statutory Authority G.S. 131E-104. 

.0409 IMPLEMENTATION OF HEALTH CARE 
PLAN 

All parts of the plan of care s hall be assigned to specific 
disciplines or staff ao indicat e d in th e plan of oar e to assur e 
that health oar e and r e habilitativ e services ar e p e rform e d 
daily and documented for those patients and residents who 
required s uch services. 

Statutory Authority G.S. 13 IE- 104. 

SECTION .0500 - NURSING SERVICES 

.0505 NURSING/HEALTH CARE 

ADMINISTRATION AND SUPERVISION 

—(a) — A licensed facility shall have a Director of Nursing 
s e rvic e who shall b e r e sponsibl e for th e overall organization - 
and manag e m e nt of all nursing sorviooo and shall bo 
currently licensed to practice as a regi s tered nurse by the 
North Carolina Board of Nu rs ing in accordance with G.S. 
9 0, Artiol e 9A. 

(b) Th e Dir e ctor of Nursing shall not s e rv e ao Adminio 
trator or Assistant Administrator. 

(c) A licensed facility, with nursing facilitie s or combina 
tion facilities shall provide a full time Director of Nursing 
on duty at l e ast e ight hours p e r day, fiv e dayo a w ee k. — A 
r egi s tered nurse s hall relievo the Director of Nursing (be in 
charge of nursing) during the Director's absence. 

(d) A l i c e ns e d facility shall e mploy and aooign registered 
nurs e , licensed praotioal nurooo and nurse aid e o for duti e o in 
accordance with G.S. 90, Article 9 A. 

— (o) The Director of Nursing shall cau s e the following to 

b e aooomplioh e d: 

(4-) e stablishment and implementation of nursing 

policies and procedures which shall include but 
not bo limited to the following; 

(A) — assessment of th e planning for patiento' nuro 

ing oar e or h e alth oare needs, and impl e m e nta 
tion of nursing/health care plans; 

(B) — daily charting of any unu s ual occurrence s of 

aout e e p i sod e s r e lat e d to pati e nt oar e , and 
progress not e s written monthly r e porting e aoh 
patient's — p e rforma nce — in — accordan ce — wkh 
identified goal s and objective s and each pa 
ti e nt's progress toward rehabilitative nursing 
goals; 

(€) — assurance of the delivery of nursing services in 

accordance with phy s icians' order s , nur s ing 



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66 



PROPOSED RULES 



oaro plans and the facility's poliotoo and prooo 
dur e s; 

-(D) — notification of omerg e noy phyoioiano or on oall 
physician s ! 

-(E) — infection control to provont cross infection 
among pationto and staff shall b e in oonfor 
monoo with 2 9 CFR 1910 (Oooupatioool Saf e ty 
and Health Standards) which i s incorporated by 
reference including subsequent amendments. 
Emphaoio ohall b e plac e d on oomplianoe with 
29 CFR 1910 1030 (Bloodbourn e Pathog e ns). 
Copies of Title 29 Part 1910 may bo purchased 
from the Superintendent of Documento, U.S. 
Gov e rnm eat — Printing — Offio e , — Washington, 
D.C. 20102 for $3 8 .00 or may bo purchased 
with a credit card by telephone to the Govern 
mont Printing Office at (202) 7 8 3 323 8 . 
Inf e ction oontrol shall also b e in oompliano e 
with the Center of Dio e ao e Control Guidelin e s 
as published by the U.S. Department of Health 
and Human Services, Public Health Service 
whioh is incorporated by referenc e including 

subsequent am e ndm e nts. Copi e s may b e 

purohaoed from the National Tochnioal Infof 
motion Service, U.S. Department of Com 
m e ro e , 52 8 5 Port Royal Road, Springfi e ld, 
Virginia, 22161 for $15.95. 

-(F) — reporting of death s ; 

-(G) — oroorgoncy reporting of fire, patient or staff 
accid e nts or inoid e nto, or oth e r omergenoy 
situations; 

-(H) — use of protective device s or restraints to assure 
that each pati e nt or resident is restrained 4b 
accordance — with phyoioian — orders and the 
faoility' s polioi e s, — and that th e r e strain e d 
patient or resident i s appropriately evaluated 
and released at a minimum of every 2 hours 1 , 

—(f) — sp e cial skin oar e and d e oubiti cor e ; 

— (F) — bow e l and bladder training; 

-(K) — maintenance of proper body alignment an d 
restorative nur s ing care; 

-(t) — supervision — of and assisting pationto with 



-W- 



-m- 



feeding; 

intake and output observation and reporting for 



thooe patients whoso condition warrants moni 

toring of their fluid balano e . — This will include 

thooe pati e nts on intrav e nouo fluids or tub e 

feedings, and patients with kidney failure and 

temperatures elevated to 102 degree s F. or 

abov e ; 

oath e t e r oar e ; and 



-m- 



-m- 



-(0) — procedures used in caring for patients in the 
facility, 
d e velopment of written job description s for 



nursing p e roonnol; 

periodic assessment of the nursing department 
with identification of personnel requirements as 
they relate to pati e nt oare needs and r e porting 



-£)- 



-&- 



-<&- 



same to the Administrate s 

a plann e d ori e ntation and continuing inoorvioe 

e ducation program for nursing e mployeoo and 

documentation of staff attendance and subject 

matter cove r ed during inooryioo education pro 

gramo; 

obtaining and provision of appropriate r e ference 

materials for the nuroing Department, which 

include a Physician's Desk Roforonoo or oompa 

rablo drug r e f e r e no e , — policy and prooodure 

manual, and medical dictionary for e ach nursing 

station; and 

establishment of operational procedures to assure 

that appropriate suppli e s and e quipment ore 

available to nursing staff as d e t e rmin e d — by 

individual patient oaro needs. 



Authority G.S. 13 IE- 104; 42 U.S.C. 1396 r (a). 

.0506 VACANT DIRECTOR OF NURSING 
POSITION 

(a) Th e Administrator shall notify the D e partm e nt within 
72 hours wh e n th e Director of Nursing position b e com e s 
vacant and shall provide the name and license number of the 
individual who i e acting Director or the replacement fo r the 
Dir e otor of Nursing. 

(b) A faoility shall not op e rate without e ith e r a Direotor 
of Nursing or acting Director of Nursing. 

— (c) The Admini s trator shall employ a Director of Nursing 
within 30 day s after a position b e oomoo vaoant. — A vaoanoy 
whioh e xceeds 30 days ohall bo reviewed by th e D e partm e nt 
for action relative to licensure status of the facility. 

Statutory Authority G.S. 13 IE- 104. 

.0507 NURSE STAFFING REQUIREMENTS 

— (a) — A licensed facility shall provide licensed nursing 
personn e l sufficient to accompli oh the following: 
(+) pati e nt needs aooooom e nt, 






patient oaro planning, and 



supervisory function s in accordance with the 

levels of patient or r e sid e nt oaro advortiood or 

offer e d by the facility. 
The facility also shall provide other nursing porsonnol 
sufficient to assure that at least activities of daily living, 
p e rsonal grooming, restorativ e nuroing actions and oth e r 
h e alth oaro needs as id e ntifi e d in e aoh pati e nt's or resid e nt's 
plan of care are mot. 

— (b) A licensed multi storied facility (one having more than 
on e story) shall provid e at least on e person on duty on e aoh 
pati e nt oar e floor at all tim e s. 

— (e) — Daily direct patient care nursing staff, licensed and 
unlicensed, s hall equal or exceed 2.1 nur s ing hours per 
pati e nt. (This is som e tim e s referr e d to as nursing hours p e r 
pati e nt day or NHPPD or NH/PD.) 
(4} Inclusive in tho s e figures i s the requirement that 

at least one licensed nurse is on duty for direct 

pati e nt oar e at all times; and 



< 



67 



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10:2 



PROPOSED RULES 



(3) Nursing cnro shall include tho services of a 

regist e r e d nurse for at least oight oons e outiv e 
hours a day, s e v e n days a w ee k. — This ooverag e 
can bo spread over moro than one shift if such a 
need exists. — The Director of Nursing may b e 
oountod ao mooting tho requirem e nt!) for both th e 
Dirootor of Nursing and patient and r e sid e nt 
staffing for facilities of a total census of 60 bods 
or loss. 

(5) Nursing — support — personn e l — including — ward 

olorka, s e cr e tari e s, nuro e e duoators and p e rsons 

in primarily administrative managomont positions 

and not actively involved in direct patient care 

shall not b e oount e d toward oomplianoe with 

minimum daily r e quir e m e nts — for dir e ot oar e 

s taffing. 

(d) — All exceptions to mooting the minimum staffing 

requir e m e nts shall be reported to tho Departm e nt at th e e nd 

of e aoh month. — Staffing waivers grant e d by th e f e d e ral 

government for Medicare and Medicaid oortifiod bods shall 

bo accepted for licen s ure purpose s . 

( e ) — Th e ratio of mal e to f e mal e nurse aides will b e 
determin e d by tho seeds of th e pati e nts, particularly th e 
number s of male patients requiring assistance with personal 



Authority G.S. 131E-104; 42 U.S.C. 1396 r (b)(4)(c). 

.0510 DOMICILIARY HOME PERSONNEL 
REQUIREMENTS 

(a) — Tho Administrator shall designate a p e rson to b e in 
charge of tho domiciliary homo residents at all times. — The 
nurse in charge of tho nursing facility may also servo as 
sup e rvisor in oharg e of th e domioiliary hom e or b e d s . 

(b) — If domioiliary hom e b e ds ar e located in a s e parate 
building or a separate lovol of the same building, there must 
bo a person on duty in tho domiciliary homo at all times. 

(o) — A lic e ns e d facility shall provide suffici e nt staff to 
assure that activiti e s of daily living, p e rsonal grooming, and 
assistance with eating are provided to each resident. 
Medication admini s tration as indicated by each resident's 
condition or phyoioian's orders shall be carri e d out as 
id e ntifi e d in e aoh r e sident's plan of oare. 

(d) Domiciliary homo facilities (Homo for tho Aged bods) 
licensed as a part of a combination facility' shall comply with 
th e staffing r e quir e ments of 10 NCAC 42D .H07 as 
adopted by th e Social S e rvio e s Commisaion for freestanding 
domiciliary homo s . 

Authority G.S. 131E-104; 42 U.S.C. 1396 r (a). 

.0511 REHABILITATIVE NURSING AND 
DECUBITUS CARE 

— Eaoh pati e nt or r e sident shall bo giv e n oar e to pr e v e nt 
oontraotur e s, d e formiti es , and dooubiti, including but not 
limited tet- 
— (+) changing positions of bedfast and chairfast patients 



or residents ovory two hours and administering 
simpl e pr e v e ntiv e oare; — Docum e ntation of such 
oar e and outoom e must b e inolud e d in routin e 
summarie s or progre ss note s ; 

— (¥) maintaining proper alignment and joint movement 

to pr e v e nt oontraotures and d e formiti e s, which 
must b e documented in routin e summari e s or 
progress note s ; 

— (£) implementing an individualized bowel and bladder 

training program e xo e pt for pati e nts or r e sid e nts 
whos e r e oordo ar e dooum e nt e d that ouch training 
is not effective; — a monthly summary for patients 
and quarterly summaries for domiciliary residents 
shall be written relative to e aoh pati e nt's or r e si 
dent's p e rformanc e in th e bow e l and bladd e r 
training program. 

Authority G.S. 131E-104; 42 U.S.C. 1396. 

.0512 MEDICATION ADMINISTRATION 

(a) A licensed facility s hall have policie s and procedures 

gov e rning th e administration of m e dioations which shall b e 

e nforc e d and impl e m e nt e d by administration and staff. 

Policies and procedures shall include but not be limited to; 

(+) automatic stop orders for treatment and drugs; 

(3) accountability of controll e d subotano e s as d e fin e d 

by th e North Carolina Controll e d Substanc e s 
Act, G.S. 90, Article 5; 

(3) dispensing and administering behavior modifying 

drugs, such as hypnotios, s e dativ e s, tmnquiliz 
e rs, antidepressants and oth e r psychoth e rap e utic 
agents; insulin; intravenous fluids and modioa 
tions; — cardiovascular — regulating — drugs; — aaA 
antibiotio s . 
(b) — All m e dioations or drugs and tr e atm e nts shall b e 

administered and discontinued in accordance with signed 

phy s ician' s orders which are recorded in tho patient's or 

r e sid e nt's m e dical r e oord. 

(44 Only physioions, — r e gist e r ed — nurs e s, — licens e d 

practical nurses or physician assistants, if in 
accordance with tho assistant's approved prac 
tio e , shall administ e r m e dioations. 

(3) To e nsur e accountabil i ty, any m e dioation shall 

bo administered by tho same licensed personnel 
who proparod the dose for admini s tration r 

(3) M e dioations shall b e administ e r e d within a h alf- 
hour prior to or half hour after th e pr e scrib e d 
time for administration unless precluded by 
emergency situation s . 

(4) The — p e rson — administ e ring — m e dioations — shall 

id e ntify' e aoh pati e nt or r e sid e nt in accordanc e 
with tho facility's policies and procedures prior 
to administering any medication. 

($) Medioation(s) administ e r e d to a pati e nt or r e si 

d e nt shall bo r e cord e d in th e pati e nt's or r e si ' 
dent's medioation administration reoord immedi 
atoly after administration in accordance with tho 



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facility's policies and proooduros. 
(4) Omiooion of m e dication s and the r e ason for th e 

omiooion ohall b e indicated in th e pationt'o or 

roaidont'o modioal record. 
(2} The person admini s tering medications which ore 

ordered to be givon ao noodod (PRN) shall 

juotify the need for th e sam e in the pationt'o or 

resident's modioal record. 
(8) Medication administration rooordo shall provide 

identification of the drug and str e ngth of drug, 

quantity of drug administ e r e d, nam e of adminio 

toring employee, title of employee and time of 

administration. 
(o) Self administration of m e dicat i ons shall b e p e rmitt e d 
only if proooribod by a phys i cian and dir e ctions ar e printed 
on the container. 

— -(d-) — The admini s tration of one patient' s or re s ident' s 
medications to another pati e nt or resident is prohibited 
except in th e eas e of an emerg e ncy. In th e e v e nt of s uch an 
emergency, stops shall bo taken to assure that the borrowed 
med i cations shall bo r eplaced promptly and so documented. 

Statutory Authority G.S. 13 IE- 104. 

.0513 ORIENTATION AND STAFF 
DEVELOPMENT 

— (a) — A lioonsod facility ohall provid e for all pati e nt or 
re s ident oaro employees a planned orientation and continuing 
education program emphasizing patient or resident assess 
m e nt and planning, aotiviti e o of daily living, p e rsonal 
grooming, rehabilitative nursing or reotorotiv e oar e , oth e r 
patient or resident care policies and procedures, patients' 
rights, and staff performance expectat i ons. — Attendance and 
s ubj e ct matter cov e red ohall b e docum e nt e d for e aoh s e ssion 
and availabl e for lioonouro insp e ctions. 

(b) The Administrator shall assure that each employee is 
oriontod within the first week of employment to the facility' s 
philosophy and goals. 

(o) Eaoh e mploy ee shall hav e sp e oifio on th e job training 
ao necessary for the employee to properly perform hi s 
individual job assignment. 

Statutory Authority G.S. 131E-104. 

.0514 NURSE AIDE QUALD7ICATIONS 

(a) Eff e otiv e Ootobor 1, 1 98 9 a faoility ohall not us e as a 
nurs e aid e , any individual not qualifying und e r th e provi 
sions of Rule .0515 unless the individual i s within the first 
four months aftor being hired. 

— (¥) — Nurs e aid e s qualifi e d und e r th e provisions of Rul e 
.0515 who oxpori e no e a p e riod of 21 oono e outiv e montho or 
more of not being activoly employed in delivering nursing 
s ervice s shall bo considered unqualified. — Qualification may 
be — reestablished — by — ouoo e oofully — passing an approv e d 
comp e tency evaluation. — Any individual, nursing homo, or 
education facility may offer Department approved vocational 
education for nursing homo nur s e aides. 

(o) An accurat e r e cord of nurs e aide qualifications shall 



bo maintained for each nurse aide used by a faoility and 
shall b e retain e d in the g e n e ral personnel files of the 
faoility. 

Statutory Authority G.S. 131E-104; 143B-165; 42 U.S.C. 
1395; 42 U.S.C. 1396. 

.0515 APPROVED NURSE AIDE EDUCATION 

— Effective Ootobor 1, 19 8 9 the curriculum content required 
for nurs e aid e e duoation programs shall b e subj e ct to 
approval by th e Division of Facility S e rvio e o and shall 
include, ao a minimum, basic nursing skills, personal care 
skills, cognitive, behavioral and social oaro, basic resto r ative 
s e rvic e s, and pati e nts' rights. Succ e ssful course complet i on 
shall b e determin e d by passing a comp e tency e valuation test. 
The minimum number of course hours shall bo 75 of which 
at least 20 hours shall bo classroom and at least 40 hours of 
sup e rvis e d practical e xp e ri e nc e . — Th e initial orientation to 
th e faoility ohall b e e xoluoiv e of the 75 hour training 
program. Competency evaluation shall be conducted in each 
of the following areas; 

— (+) Observation and docum e ntation, 

—(3) Baoio nursing skills, 

— (3} Personal oare skills, 

— {A) Mental health and social service needs, 

— {$) Basic r e storativ e s e rvio e o, 



— f4) R e sid e nts' Righto. 

Statutory Authority G.S. 131E-104; 143B-165; 42 U.S.C. 
1395; 42 U.S.C. 1396. 

.0516 COMPETENCY EVALUATION 

(a) — Suooossful course completion and skill oompotoncy 
shall bo determin e d by oompotenoy e valuation approv e d by 
the Department. 

—(h) — Commencing July 1, 19 8 9, nurse aides who had 
formerly boon fully qualified under nurse aide training 
r e quirements — H*ay — re establish — th e ir — qualifica tions — by 
ouoo e oofully passing a oompot e noy e valuation t e st. 

Statutory Authority G.S. 131E-104; 143B-165; 42 U.S.C. 
1395; 42 U.S.C. 1396. 

.0517 NORTH CAROLINA NURSE AIDE REGISTRY 

The function of the North Carolina Nuroe Aide Registry 
io to maintain a o e ntral listing of r e gistered nurs e aides. 
Eff e otiv e January 1, 1990 t a faoility ohall not p e rmit -aa 
individual to work as a nurse aide for a period longer than 
four months without verifying the person's registry or 
ouoo e ooful compl e tion of an approv e d training progr am^ 

Statutory Authority G.S. 131E-104; 143B-165; 42 U.S.C. 
1395; 42 U.S.C. 1396. 

SECTION .0600 - MEDICAL RECORDS 

.0605 POLICES AND PROCEDURES 

Eaoh lio e no e d faoility ohall hav e polici e s and proc e dur e s 



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which shall bo implemented to provide for at loaot the 
following: 

maint e nance of oompl e to and aoourat e m e dioal 



-&h 



-&- 



records for each patient admitted to the facility; 
filing of medical records to ensure aooossibility for 
oompiling or r e trieving information f 
ouporvioion of medioal reoordo; 



Statutory Authority G.S. 13 IE- 104. 

.0608 PATIENT INDEX 

The Administrator shall assure that a master patient index 
is maintained — listing patients alphabetically — by name, 
id e ntifying information, dates of admiooion and disoharge 
and oas e numb e r. 



-(4) confidentiality of records; 

-(5) accessibility or non accessibility of medical record Statutory Authority G.S. 131E-104. 



information to th e pati e nt or logal guardian, 
faoility staff and non e mployees of th e faoility; 
retention of records; 



— (7) disposition of records; and 

— (8) oharting and indexing of records. 

Statutory Authority G.S. 13 IE- 104. 



.0606 SUPERVISION AND SPACE 

— (a) An e mployee who works fulltim e in the faoility shall 
bo designated to bo responsible for the modical record 
services. — If that employee i s not qualified by training -ef 
e xp e ri e no e in modioal rooord soiono e , — he shall r e o e ive 
oonoultation from a register e d r e cord administrator or an 
accredited record technic i an as determined by noods of the 
facility and to assure compliance with wiles contained in this 
Subchapt e r. 

(b) — M e dioal r e cord work space shall be so locat e d to 
assure that records are protected from unauthorized disclo 
sure. All modical records shall bo stored in a protected or 
sup e rvis e d e nvironm e nt. 



Statutory Authority G.S. 131E-104. 

.0607 CONTROL AND RETENTION 

(a) Medioal reoords shall not b e remov e d from th e faoility 
except by oourt order. 

(b) The facility's policy relative to retention of modical 
reoords shall assure that either the original or a copy of e aoh 
pati e nt's or r e sident' s m e dioal r e cord i s r e tain e d in th e 
faoility regardless of change of ownership or Administrator 
in accordance with North Carolina statutes of limitations for 
both adults and minors (G.S.I IS, 1 17). 

(o) — A plan for d e struction of m e dioal reoords shall 
identify information to be retained and the manner of 
de s truction to ensure confidentiality of all material. 

(d) Provisions shall bo mad e for a pati e nt or r e sid e nt or 
hio l e gal guardian to hav e aoo e s s to th e information oon 
tainod in his modical record unless ordered otherwise by the 
patient's or resident's physician. 

( e ) — Sign e d authorization forms oonoorning approval or 
disapproval of r e l e as e of m e dioal information for lio e nour e 
inspections shall be a part of each patient's and resident's 
modical record. Representatives of the Department shall bo 
notifi e d at th e tim e of insp e otion of th e nam e and r e cord 
numb e r of any patient or r e sid e nt who has d e ni e d m e dioal 
record access to the Department. 



.0609 CONTENT OF MEDICAL RECORD 

(*) — All entries in the rooord shall bo dated, legible and 

signed by the individual making the entry with signature and 

titles — If initials are us e d the rooord must oarry a rooord of 

e aoh e mploy ee 's full official signatur e and signatur e initials 

used in lieu of full signature, 
(b) — The patient's or resident's name and case number 

must b e r e oord e d on e aoh pag e of th e r e cord, 
(o) Th e m e dioal record shall contain at l e ast th e following 

information when applicable! 

(4) identification data [name, address, ago, box, 

marital status, (nam e , addr e ss, and telephon e 
numb e r of n e xt of kin, l e gal guardian or both)]; 

(3) admission data, including modical history and 

physical examination ; hospital discharge sum 
mary (if th e pati e nt or r e sid e nt io admitted from 
th e hospital); admission diagnosis; and rehabili 
tation potential, all of which must be signed by 
a physician; 

(5) transf e r form; 

(4) diagnostic r e ports; 

($) consultation reports; 

(6) physician' s orders which are signed by the 






physician; 

physician's progr e ss not e s; 

modioal and treatment record s , which include 



laboratory, x ray, dental examination, physical 
th e rapy r e ports, e tc.; 
graphio sh ee t; 



-m- 



medication administration sheet; 



— (44-) diabetic shoots; 

— (4-3) pati e nt assessm e nt and progr e ss notes by various 

disc i plines; 

— (45) miscellaneous such as consent and release forra sr 

copy of transfer forms to tho receiving institu 
tion, disoharge order or release of liability for 
th e faoility if th e pati e nt or r e sid e nt l e av e s 
against doctor's orders; and 

— (44) discharge summary including admitting and final 

diagnosis and/or prognosis or oaus e of d e ath. 

Statutory Authority G.S. 13 IE- 104. 

SECTION .0700 - PHYSICIAN SERVICES 

.0705 POLICES AND PROCEDURES 

— (a) — Each licensed facility shall have policies and proce 



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duroo which arc implemented to assure that the medical or 
health oaro of oaoh pati e nt or rooidont io undor the oontinu 
ing supervision of a physioian. — Physioian sorvio e s shall 
include at least those physician services roquirod in Section 
.0300 of this Subchapter. 

— (b) — Modioal ordors for all m e dications and tr e atm e nts 
administ e r e d to any patient or rooid e nt shall b e sign e d and 
dated by the attending physician. All current orders shall be 
s igned and dated by the phy s ician at least every 60 days. 
— (o) A physioian's oral orders (including t e l e phon e ord e rs) 
shall b e giv e n only to a lic e nc e d nurs e or oth e r licensed 
professionals who by law aro allowed to accept phy s ician' s 
order s , except ordors for therapeutic diets which shall bo 
given e ith e r to a qualifi e d di e titian or licensed nurs e . — The 
record of oaoh tel e phon e order shall includ e th e nam e of 
physician giving the order, date and time of orde r , content 
of order and name of person receiving the order. — The 
phy s io i an who gives oral ord e rs shall sign th e ord e rs within 
fiv e days and in aooordano e with th e facility's writt e n 
policies, 

(d) Standing ordor s shall bo identified for oaoh patient and 
s ign e d by the physioian. 

( e ) All di s charg e ord e rs and instructions shall bo oign e d 
by a phy s ician. 

Statutory Authority G.S. 13 IE- 104. 

.0706 ADMITTING PHYSICIAN 

The admitting physician shall bo responsible for the 
pati e nt' s m e dioal oare until ouch tim e as ord e rs ar e r e c e iv e d 
from th e pati e nt's attending physioian. 

Statutory Authority G.S. 13 IE- 104. 

.0707 EMERGENCY PHYSICIAN 

A facility shall designate a physician or physician group 
practice to provide emergency services to patients whenever 
th e r e gular physioian oannot b e r e ach e d. — Th e nam e and 
t e l e phon e numb e r of th e d e signat e d e m e rg e noy s e rvio e 
physician or group s hall be po s ted at each nursing station. 

Statutory Authority G.S. 13 IE- 104. 

.0708 PRIVATE PHYSICIAN 

Each patient or legal guardian shall bo allowed to select 
hie private physioian except in those faciliti e s affiliat e d with 
m e dioal toaohing programs and having writt e n polici e s 
requiring all patients to participate in the medical teaching 
program. 

Statutory Authority G.S. 131E-104. 

.0709 DOCUMENTATION 

—(a) — Th e phyoioion shall s ee th e pati e nt every 60 day s in 
th e nursing faoility. — A physioian visit io consid e r e d tim e ly 
if it occurs not late r than 10 days after the date the visit was 
required, 
(b) Every physioian's visit shall b e documented with an 



entry in the physician's notes. 

(o) Physioians shall r e vi e w and sign all discharg e summn 
ri e s oo r e quir e d by Rul e .060 9 of this Subchapter. 

Authority G.S. 13 IE- 104; 42 U.S.C. 1396 r (a). 

.0710 USE OF PHYSICIAN EXTENDERS 

The Administrator s hall have on file a current agreement 
between the Board of Medical Examiner s and a sponsoring 
physioian conc e rning — e aoh physioian aooiotant or nuro e 
practition e r visiting pati e nts. — Th e physioian assistant's or 
nurse practitioner's privileges in the nur s ing homo must bo 
clearly defined by the fac i lity's policies and procedures and 
must b e limited to those privileges grant e d by th e Board of 
M e dioal Examin efSr- 

Statutory Authority G.S. 131E-104. 

.0711 BRAIN INJURY LONG-TERM CARE 
PHYSICIAN SERVICES 

(a) — For nursing facility patients located in designated 
brain injury long term oaro units, th e r e shall b e an attending 
physioian who io responsibl e for the patient's sp e cialized 
care program. — The intensity of the program requires that 
there shall bo direct patient contact by a physioian at leas t 
ono e p e r week and mor e oft e n as th e pati e nt's condition 
warrants. — Eaoh pati e nt's interdisciplinary, r e habilitation 
program shall bo developed and implemented undo r the 
supervision of a physiatrist (a phy s ician trained in Physical 
M e dicin e and R e habilitation) or a physioian of e quivalent 
training and experience. 

(b) If a physiatrist or physician of equivalent training or 
experience is not available on a weekly basis to the facility, 
th e faoility shall provid e for w ee kly m e dioal management of 
th e pati e nt by another physioian. In add i tion, oversight for 
the patient's interdisciplinary, long term care program s hall 
bo provided by a qualified consultant phy s ician who visits 
pati e nts monthly, mak e s r e comm e ndations for and approv e s 
th e interdisciplinary oare plan, and provid e s consultation as 
requested to the physician who is managing the patient on a 
weekly basis. 

—(e) — Th e att e nding physioian shall act i v e ly part i cipat e in 
individual ease conferences or oar e planning ooooions and 
shall review and sign discharge summaries and records 
within 15 day s of a patient discharge. — When patients ore to 
b e discharg e d to e ither anoth e r h e alth oar e faoility or a 
r e sid e ntial s e tting, the attending physioian shall assur e that 
the pationt has boon provided with a discharge plan which 
incorporates optimum utilization of community resources 
and poet discharg e oontinuity of oar e and s e rvio e s. 

Statutory Authority G.S. 131E-104. 

.0712 PHYSICIAN SERVICES FOR VENTILATOR 
DEPENDENT PATENTS 

Nursing facilitie s with ventilator dependent oaro patients 
shall contract with a physician who is licensed to practice in 
North Carolina with Board C e rtification and who has 



t 



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PROPOSED RULES 



facility. 

(o) S e rvic e s shall inolud e docum e nt e d on site pharmac e u 
tiool r e vi e ws aooomplieh e d at leant every 31 oalondar days 
for all patients and residents. 



specialized training in pulmonary medicine. — This phyoioian 
shall b e rooponoiblo for r e spiratory Qorvioos and ohall: 
— (4) establish, with th e r e spiratory therupiot and nuro 

«g — staff, — appropriate — ventilator — policies — aad 

procoduroa, including omorgoncy procedures; 
—(3) assooo e aoh v e ntilator patient' o status at l e ast Statutory Authority G.S. 13 IE- 104. 

monthly with corresponding progress not e s; 

— (3) bo available on a omorgoncy basis; and 

— (4) participate in individual patient care plannin gr 



Statutory Authority G.S. 13 IE- 104. 

SECTION .0800 - DENTAL SERVICES 

.0810 DENTAL EXAMINATION 

— A dental examination shall bo performed at the time of 
admission with the following information being placed in the 
pati e nt's or resid e nt's m e dioal or h e alth oar e r e cord: 
— (4} typo of diet whioh th e pati e nt or r e sident oan boot 

manage (such as normal, soft or pureed); 

—(3) the presence of infection of gums, tooth, or jaws; 

(3) briof descr i ptions of any r e movabl e d e ntal appli 

onoes and a stat e m e nt of th e ir condition; and 
— (4) indications for dental treatment at the time of 

admission. 

Statutory Authority G.S. 13 IE- 104. 

.0811 EMERGENCY DENTAL CARE 

Nam e s of d e ntists who have agreed to render em e rg e ncy 
dental oare shall b e maintained at eaoh nuroing station and 
at the supervisor's station in a domiciliary homo. 

Statutory Authority G.S. 13 IE- 104. 

.0812 GOOD PRACTICES OF ORAL HYGDZNE 

Staff of the facility s hall ensure that! 
— (49 n e o e soary doily d e ntal oar e is provid e d; 



.0904 PHARMACEUTICAL SERVICES 

PROVIDED THROUGH OTHER MEANS 

If pharmaoeutiool servic e s ar e provid e d through m e ans 
oth e r than by an employee of the facility, th e r e shall b e a 
written agreement between the facility and the pharmacist 
which shall include the following! 

— (4) a statem e nt of th e r e sponsibiliti e s of e aoh part)'; 

— (3) a r e quirem e nt for th e pharmaci s t to submit to th e 

Administrator and the patient's attending physician 
written reports of any discrepancies — in drug 
accountability or administration. 

Statutory Authority G.S. 131E-104. 

.0905 ADMINISTRATIVE RESPONSD3ILITDZS 

(a) The Administrator shall maintain r e ports of dioor e pan 
cio s in drug accountability or drug administration submitted 
by the pharmacist and shall make those reports available for 
th e Dir e ctor of Nursing and th e Departm e nt's r e pr e sentativ e 
for lio e nsuro insp e ction. 

(b) — The Admini s trator shall provide documentation of 
action taken relative to di s crepancies identified by the 
pharmacist whioh shall b e availabl e for lio e nsur e insp e o 



Statutory Authority G.S. 131E-104. 

.0906 PHARMACEUTICAL SERVICES 
COMMITTEE 

(a) — The Admini s trator shall appoint a pharmaceutical 
o e rvio e s oommitte e whioh shall b e oompos e d of at l e ast th e 



-(3) e aoh pati e nt or r e sid e nt possess e s appropriat e pharmacist and d e signated representat i v e s of administration, 

nursing and physician s ervice s . 

(b) A pharmaceutical services committee shall: 
(4) e stablish it e ms and quantities for e m e rg e ncy 



toothbrushes and is encouraged and, when ncce e 
sary, assisted in their use; and 



-&- 



e aoh — pati e nt — or r e sid e nt having a r e movabl e 



d e ntur e s is furnished a r e c e ptacl e in whioh to 
immerse the dentures in water overnight. 

Statutory Authority G.S. 131E-104. 

SECTION .0900 - PHARMACEUTICAL SERVICES 

.0903 AVAILABDLITY OF PHARMACEUTICAL 
SERVICES 

— (a) — A licensed — facility — shall provide pharmaceutical 
services under the supervision of a pharmaci s t currently 
lic e ns e d to practic e pharmaoy in North Carolina. 
— (b) — A facil i ty shall b e r e sponsibl e for obtaining drugs, 
therapeutic nutrients and related products proscribed or 
ordered by a physician for patients or residents in the 



drug kit; 

-(3) moot at least annually and more often as change 

in conditions may dictate for reviewing pharm a- 
c e utical s e rvio e s; — th e r e shall b e writt e n doou 
m e ntation of th e s e r e vi e ws including dat e s, 
attendance, busine s s discussed, action taken, and 
other relevant matters; — those minutes shall bo 
availabl e in th e faoility for at least two y e ars; 

-(£) develop and/or approve and annually r e vis e 

pharmaceutical policies and procedures; 

-(4) approve staff insorvico training de s igned to 

improv e staff skills and/or oorroot id e ntifi e d 
problems; and 

-(5) approve non legend drugs maintained in th e 

faoility and a written formulary for same. 



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PROPOSED RULES 



(c) Tho pharmacist ahnll bo a member of the pharmao eMti- 
ool sorvioos oommittoo and shall part i c i pate in drug utilize 
tion review and report to th e oommitto e at l e ast annua Hy-en 
tho status of tho facility's pharmaceutical services and staff 
porformnnco. 

Statutory Authority G.S. 13 IE- 104. 

.0907 DRUG PROCUREMENT 

—(a) — Nursing homoo shall not b e p e rmitt e d to possess a 
stock of proscription l e g e nd drugo for g e n e ral or oommon 
use except as permitted by tho North Carolina Board of 
Pharmacy and as follows: 

fi) for all intrav e nous and irrigation solutions in 

single unit quantities e xoooding — 19 ml. Bad 
related equipment for tho use and administration 
of such; 
(3) diagnostic agon to; 



-(4)- 



vaooin e c; 



drugs des i gnated for inclusion in an approved 
emergency kit; 
{§} water for injection; and 



-&h 



normal salin e for inject i on. 



(b) Patient Drug s . 

£±} Tho contents of all proscriptions shall bo kept in 

th e original oontainor bearing tho original lab e l 
as d e scrib e d in (b)(2) of thi s Rul e . 

(3) Except in unit dose systems, each individual 

patient's or resident's proscription or legend 
drugs shall b e lab e l e d with tho following infor 
motion: 

(A) — tho name of tho patient for whom tho drug i s 

intended; 

(B) — th e moot r e c e nt date of issu e ; 

(€) — tho name of the prosorib e r; 

(©) — tho name, concentration of the drug, quantity 

dispensed, and proscription sorial number; 

(E) — a statem e nt of g e n e ric e quival e ncy which shall 

b e indicat e d if a brand other than th e brand 
proscribed is dispensed; 

(F) — the expiration date and other auxiliary state 

m e nto as requir e d of th e drug; 

(G) — th e nam e , addr e ss and tel e phon e numb e r of th e 

dispensing pharmacy; and 
(H) — tho name of tho dispensing pharmacis ts 

Statutory Authority G.S. 13 IE- 104. 

.0908 DRUG STORAGE 

(a) Exc e pt for e m e rg e ncy drug kit and properly s e cured 
modioation oarts, all proscription or legend drugs shall be 
stored in a locked room or locked wall cabinets except whon 
tho drugs are under tho immed i ate, direct physical supervi 
oion of a lio e no e d nurse or pharmacist. — Non l e g e nd or 
non pr e ooription drugs shall b e stored in an area whioh is 
locked whon not in use and aooossiblo only by authorized 
individual s . 
—(b) — Em e rgenoy drug kit shall b e stor e d in a r e asonably 



secure area out of tho sight of patients and tho general 
public 

(o) — Drugo requiring rofrigoration shall b e stored in a 
thermometer equipped refrigerator capable of maintaining a 
temperature range of 2!C. to 8 !C. (36!F. to 4 5!F.), Drug s 
shall not be stored in a refrigerator containing non drugs 
and non drug related items, e xo e pt wh e n stored in a separate 
looked containe r . 

(d) — Drugs intended for topical use shall bo stored in a 
d e signated area separate from drugs intend e d for oral and 
inj e ctabl e us e . 

(o) Tho pharmacist shall remove outdated and deteriorated 
drugs from tho facility within 30 days after their period of 
e ff e ctiveness has lapsed. 

Statutory Authority G.S. 131E-104. 

.0909 PHARMACEUTICAL RECORDS 

Th e pharmacist shall aooure that accurat e r e cords of th e 
receipt, use and/or other disposition of drugs are maintained 
and readily available. 

Statutory Authority G.S. 13 IE- 104. 

.0910 EMERGENCY DRUGS 

(a) — Th e facility shall maintain a supply of e morgoooy 
drugs. 

—(b) — Emergenoy drugs shall bo stored in a portable 
oontainor sealed with an easily breakable closure which 
cannot be reooalod and shall b e r e adily aoooosiblo for uoo. 

(o) — All e merg e noy drugs and quantity to b e maintain e d 
shall bo approved by tho pharmaceutical services oommittoo. 

(d) If emergency drag items require refrigerated storage, 
th e y shall b e stored in a separate s eal e d contain e r within th e 
m e d i cation r e frig e rator. — Th e contain e r shall be label e d to 
indicate tho emergency status of tho enclosed drug(s) and 
sealed as indicated in Paragraph (b) of this Rule. 

( e ) — An aoourate inventory of emergenoy drugs and 
suppli e s shall b e maintained with oaoh emerg e noy drug kit. 

(0 The pharmaci s t shall personally examine tho refrigor 
atod and non refrigerated eme r gency drug supply at least 
e very 90 days and mak e any necessary ohong e s at that tim e . 

(g) Th e faoility shall hav e writt e n polioi e o and procedures 
which are enforced to assure that in tho event tho sealed 
emergency drug container is opened and contents utilized, 
imm e diate st e ps ar e tak e n to r e plac e th e items us e d. 
— (4») — Th e availability of a controlled substance in an 
omorgoncy drug kit shall bo in compliance with current state 
and federal laws. 

Statutory Authority G.S. 13 IE- 104. 

.0911 DRUG DISPOSITION 

(a) Upon d i scharg e of a patient or resident, tho remainder 
of his drug supply shall b e dispos e d of promptly unl e ss it is 
reasonably expected that tho patient or resident shall return 
to tho faoility and in such case, tho remaining drug supply 
may b e h e ld for not mor e than 30 oal e ndar days aft e r th e 



♦ 



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PROPOSED RULES 



dato of discharge. 

(b) The diopooition of drugo ohall b e in aooordano e with 
written polioi e o and proo e dur e o e otabliohod by th e pharmn and s e rv e d ao ord e r e d. — Th e modioal r e cord ohall oontain 



.1004 DIETS 

(a) All di e to ohall bo proooribod by the pati e nt' o phyoioian 



nutritional assessments and progress no too that include! 
(+) diet hiotory and observation of food intake; 



coutical sorvicos oommittoo. 

— (e) — Accurate rooordo of drug destruction shall bo main - 
tained and authenticated by tho pharmaoist and Dir e otor of 
Nursing. 

(d) Controlled s ubstanoos shall bo dootroyod in accordance 
with provisions of tho North Carolina Controlled Substances 
Aot, G.S. 90, Artiol e 5. 

Statutory Authority G.S. 131E-104. 

SECTION .1000 - DIETARY SERVICES 

.1003 ORGANIZATION 

(a) — Tho Admini s trator shall de s ignate a person to bo 
known as th e food sorvioo supervisor who s hall be rosponsi 
bio for th e nursing hom e 's di e tary o e rvio e and di e tary 
s ervice personnel. — If this person is not a qualified dietitian, 
ho must have successfully completed a course which would evening meal containing a protein food and a morning meal 



— (3) aooooomont of body weight and form and di e tary 

r e quir e ments; and 

— (3} notes of counseling of patients and family ?- 

-fb) — Documentation of menus served shall reflect that! 

— (4-) r e gular di e t piano moot nutritional Heeds of tho 

pati e nts — in aooordano e — with ourrent — reoom 
mended dietary allowances of tho Food and 
Nutrition Board, National Research Council and 
ar e adjust e d to ag e , sex and act i vity; and 



(3) therapeutic diet plans moot nutritional standards 

as stated in (bXl) of this Rule to the extent that 
is medically possible, 
(o) — At least throe meats shall bo served daily to all 

pati e nts and r e sid e nts. 

— (d) No more than 1 4 hours s hall e lapse between an 



qualify' him for membership in the Dietary Manag e rs 
Association. — If th e oouro e has not boon oompl e t e d, this 
per s on must bo enrolled in a course and making sati s factory 
progress for completion within tho time limit specified by 
oouro e r e quir e m e nts. 

(b) — If th e food oorvioo supervisor is not a qualifi e d 
diotitian, tho Administrator shall provide for a minimum of 
eight hours per month consultation from a qualified dietitian 
or sufficient time to aooure that therapeut i c diets are planned 
and s e rv e d in aooordano e with th e physician's ord e rs. — The 
consultant shall submit written reports to the Administrator 
and food sorvioo supervisor. — The reports will bo kept on 
fil e in th e faci l ity for at l e ast two y e ars. 
— (e) — Tho food oorvioo superv i sor shall b e r e sponsibl e for 
tho total operation of tho dietary Department. — This respon 
sibility shall include coordinating dietary services with other 
faoility sorvioos; developing writt e n job descriptions; food 
purchasing; d ie tary staff ori e ntation, training and suporvi 
sion of dietary employees; participation in patient caro 
conferences; implementing current policies and procedure s ; 
and maintaining a ourr e nt r e cord of diet order for each 
pati e nt or resident who shall b e id e ntified by name, room 
and bod number and diet order. 

— (d) Dietary personnel shall bo employed and scheduled to 
m ee t tho nutritional need s of all pati e nts and r e sid e nts. 

( e ) Th e kitchen ohall bo staff e d by at least one person for 
twelve consecutive hours, breakfast through supper. 

(f) Duty assignments of dietary personnel shall bo posted 
and shall bo availabl e to staff at all timeo. 

(g) — Dietary omployooo ohall participat e in in s e rvioo 
e ducation which shall include but not bo limited to thorapou 
tic diets, food preparation requ i rements, and principles of 
sanitation. 



Statutory Authority G.S. 13 IE- 104. 



containing a protein food. 

—(e) — Betw ee n meal nourishm e nts ohall b e availabl e and 

offered to all patients and residents. 

(f) If a therapeutic diet require s a specific between moal 
nourishm e nt, docum e ntation shall aoour e th e gam e was 
served or off e r e d and r e fus e d by th e pati e nt or r e sident. 

(g) — An up to date manual approved by tho diotitian, 
medical staff, and tho Administrator s hall bo used in tho 
planning of regular and therapoutio diets. 

(h) M e nus ohall b e dated and plann e d at l e ast thr ee weeks 
in advance for both regular and therapeutic diets. — They 
shall bo posted in tho kitchen and accessible to kitchen s taff- 
All m e nus shall b e corrected as served and k e pt on fil e in 
th e faoility for a minimum of one year from th e date served. 

(i) Food must bo prepared to conserve its nutritive value 
and appearance. 

— (j) — Unless medically contra indicat e d. — foods shall b e 
s e rv e d at th e temp e ratur e or t e mperature range specified in 
tho diet manual, recipe, or package instructions, and in a 
consistency and texture to moot individual needs. — Hot food 
shall be serv e d hot and oold foods served oold and in a 
consist e ncy to m ee t individual ne eds? — If pati e nts or r e si 
dents require assistance in eating, food shall bo maintained 
at s erving temperature until assistance is provided. 

(k) — Patients' and resid e nts' food pr e f e r e nc e s must b e 
considered. However, wh e n food is substitut e d it must b e of 
a similar nutritive value as that for which it i s substituted. 



Statutory Authority G.S. 13 IE- 104. 

.1005 FOOD SUPPLIES 

The following supplies must bo available in tho facility at 
all times and suffici e nt to moot nutritional needs of tho 
pati e nts and r e sidents: 
— (+) non perishable food sufficient for a 3 day period; 



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74 



PROPOSED RULES 



— (2) perishable food gufficiont for a 2 4 hour period. 

Statutory Authority G.S. 131E-104. 

.1006 RECORDS 

Tho Adminiotrator shall maintain th e following records for 
at l e ast one year: 
— (4-) a record of all food and supplie s purchases show 

ing quantities and total co s t of all items purchased; 
— (3) daily m e al census (staff as w e ll as pationto and 

r e sid e nts); and 
— (3) labor costs for providing dietary s ervice s . 

Statutory Authority G.S. 131E-104. 

.1007 DINING FACILITIES 

Patients, including wheelchair patients, shall bo oncour 
aged to eat at th e tabl e s in th e dining ar e a and assisted wh e n 
nooossary by non dietary staff. — An ov e rbod table shall be 
provided for pationta who oat in bod. — A sturdy tray stand 
shall bo provided for those patients who oat out of bod but 
ar e unabl e to go to th e dining ar e a. — (An ov e rb e d tabl e 
which oan b e low e r e d to ohair h e ight may substitute for th e 
tray stand.) 

Statutory Authority G.S. 131E-104. 

.1008 SANITATION 

(a) Food services shall comply with tho most current rules 
for sanitation ao promulgated by th e Commission for Health 
Sorvioos. 

— (b) — All facilities shall maintain a "Grade A" sanitation 
rating. If tho grade fall s below an "A", the Administrator 
shall notify' th e D e partm e nt within T e n days. — This notifioa 
tion shall includ e a oopy of th e sanitation insp e ct i on r e port 
with a plan for corrective action which the facility shall 
accomplish within 90 days. 

— («) — Reports of sanitation insp e ctions and a r e cord of 
correctiv e aotion for any defioienoies not e d shall b e on fil e 
in tho dietary Department and maintained for at least two 
years. 

(d) — Polici e s and proo e dur e o shall b e d e v e lop e d and 
implemented to assure that dishes and ut e nsils from patients 
with communicable diseases are isolated until sterilized or 
destroyed. 

— (e) — Cl e aning soh e dulos and instructions for cleaning b H 
e quipm e nt and work and storag e ar e as shall b e post e d in th e 
dietary area and accessible to all dietary staff. 
— (f) Employees with infectious or communicable diseases 
shall not work in dietary s e rvic e s. 

(g) — A lioensod faoility must hav e a writt e n plan for 
sanitizing dishes, such ao chomioal washing, in case of 
disasters, or malfunctioning of equipment. 

Statutory Authority G.S. 13 IE- 104. 

SECTION .1100 - SPECIALLY DESIGNATED 
UNITS 



. 1 1 05 REQUIREMENTS FOR SERVICES 

— Sp e cialized rehabilitative and habilitativ e sorvioos, suoh as 
physical therapy, occupational therapy and speech therapy, 
are not required as a condition of licensure. — However, 
pati e nts r e quiring ouoh s e rvic e d shall not b e admitted to nor 
r e tain e d in a faoility unl e ss th e faoility is capabl e of furnish 
ing tho Doodod sorvioo through faoility staff and equipment 
or through contractual arrangement. — If phy s ical therapy, 
occupational th e rapy, or spoooh th e rapy ar e provided: 
— (4-) A physioian's order for sorvioos shall b e r e cord e d 

in tho patient' s or resident's rooord. 
— (2) The facility shall provide adequate space and 

appropriat e e quipm e nt — for rendering physical 

therapy or oooupational therapy sorviooo required 

by patients or residents in tho facility. 
— (3} Tho sorvioos shall bo superv i sed by a therapist 

duly lic e ns e d or oortifiad to praotioe in th e ar e a 

sup e rvised. 
— (4) Tho thorapist shall incorporate his note s pertaining 

to treatment in tho patient' s or resident's medical 

or h e alth car e r e cord. 
— (£) Th e therapist's notes shall b e availabl e for physi 

cian review. 

Statutory Authority G.S. 13 IE- 104. 

. 1 106 QUALITY OF SPECIALIZED 
REHABILITATION SERVICES 

(a) Whil e the person sup e rvising sp e cializ e d r e habilitativ e 
and habilitativ e s e rv i c e s shall b e a duly lio e nsed or oo rtifiod 
professional thorapist, all other support personnel shall bo 
trained in tho area of assignment and directly supervised by 
th e th e rapist in th e ar e a of assignm e nt. 

(b) S e rvio e s provided through outside rosouroeo shall bo 
carried out through and in accordance with written agree 
monts. 

(o) — Sorvioos shall b e d e sign e d to maintain and improv e 
th e pati e nt's or resid e nt's ability to funotion independently, 
prevent as much as possible tho advancement of progressive 
disabilities, and restore maximum function. 
— (d) If nuroing staff oany out se le cted therapy procedures, 
th e y shall do so und e r th e sup e rvision of th e physical or 
occupational thorapi s t and only after documented training 
and approval by tho thorapist. — Thi s is not to prohibit simple 
restorativ e m e asur e s by th e nursing staff. 

Statutory Authority G.S. 131E-104. 

.1107 VENTILATOR DEPENDENCE 

Th e g e n e ral r e quir e ments in this Subchapt e r shall apply 
when applicable. — In addition, facilities having patients 
requiring tho use of ventilators for more than eight hours a 
day must moot the following requirements: 
— (44 Th e faoility must bo located within 30 minutes of 

an acute care facility. 
— (2) Respiratory therapy shall bo provided and super 

visod by a r e spiratory th e rapist ourr e ntly r e gis 



I 



75 



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April 17, 1995 



10:2 



PROPOSED RULES 



torod by tho National Board for Re s piratory Care. 
Th e r e spiratory therapist ohall: 

— (a) mak e , ao a minimum, wookly on sit e ass e ss 

monta of each patient receiving ventilator sup 
port with corresponding progress notoo; 

— (b) b e on oall 24 hours daily; an d 

— (e) assist th e pulmonologiot and nursing staff in 

establishing ventilator policies and procedure s , 
including emergency policies and procedures. 

-(3) D i rect nur s ing oar e staffing shall b e in aooordano e 

with 10 NCAC 3H . 1 109. 



Statutory Authority G.S. 131E-104. 

. 1 108 BRAIN INJURY LONG-TERM CARE 

—(a) — Tho general requirements in this Subchapter shall 
apply when applicable, but brain injury long term care units 
ohall m ee t th e suppl e m e nt r e quirem e nts in Rul e s . 1 10 8 and 
.1109 of this S e ction. — Brain injury long term oar e is an 
interdi s ciplinary, intensive maintenance program for patients 
who have incurred brain damage caused by external physical 
trauma and who hav e oompl e t e d a primary oouro e of 
rehabilitative treatment and have roooh e d a point of no gain 
or progress — for more than throe — consecutive — months. 
Services are provided through a medically — super . 1 i sod 
interdisciplinary prooooo as provid e d in Rul e .07 1 1 of this 
subchapter and are direoted toward maintaining th e individ 
ual at tho optimal level of phys i cal, cognitive and behavioral 
functionin g^ — Following are the minimum requirements for 
sp e oifio servic e s that may b e necessary to maintaining th e 
individual at optimum l e v e l: 

(1) Overall — supervisory — responsibility — for brain 

injury long term care services s hall bo assigned 
to a r e gist e red nurs e with one year exp e ri e nc e in 
oaring for brain injur e d pati e nts. 

(3) Physical therapy shall bo provided by a phy s ical 

therapist with a current valid North Carolina 
lic e nce. Occupational th e rapy shall bo provided 



cal nutrition services shall include; 
-(A) — Assessing th e appropriatenooo of th e ord e r e d 

di e t for conformanc e with oaoh patient's phyoi 

ological and pharmacological condition. 
-(B) — Evaluating oaoh patient's laboratory data -in 

r e lation to nutritional status and hydration. 

Applying — t e ohnioal — knowl e dg e — of feed i ng 



-(G)- 



tubes, pumps and equipment to oaoh patient's 

specialized needs. 

-(4) Clinical socia l work shall b e provided by a 

oooial workor mooting th e r e quir e m e nts of Rule 

.1306 of this Subchapter. 

Recreation therapy, when required, shall bo 



-&- 



provid e d on e ith e r a full tim e or part time 
e mploym e nt or oontract basis by a clinician 
eligible for certification as a therapeut i c rocro 
ation specialist by tho State of North Carolina 
Th e rap e utio R e cr e ational Certification Board. 
Th e number of hours of th e rapoutio r e or e ation 
service s shall bo adequate to moot tho needs of 
tho patients. In event that a qualified specialist 
is not looally available, — alt e rnat e tr e atment 
modalitioo ohall b e developed by th e oooupa 
t i ona l therapist and reviewed by tho attending 

physician. Tho program dooignod must bo 

adequate to moot tho needs of this specialized 
population and must b e administered in aooor 
dance with Section .1200 of this Subchapter. 

(6) Speech therapy, when r equired, shall bo pro 

vid e d by a clinician with a current valid license 
in opoooh pathology iooued by tho Stat e Board of 
Audiology and Speech pathology. 

(2) Respiratory therapy, when required, s hall bo 

provid e d by an individual mooting the oumo 
qualifications for providing r e spiratory thoropy 
under Rule . 1 107 of this Section, 
(b) — Each patient's program shall bo governed by an 

interdisciplinary treatm e nt plan incorporating and e xpanding 



by an occupational th e rapist with a ourront valid upon tho health plan r e quir e d under Section .0100 of this 



North Carolina licen s e. — Tho services of a 
physical therapist and occupational therapist shall 



Subchapter. — The plan is to bo initiated on tho first day of 
admission. Upon completion of baseline data development 



b e oombin e d to provide one full tim e e quival e nt and an int e grat e d interdisciplinary assessm e nt th e initial 



position for oaoh 20 pati e nts. — Th e assistano e of 
a physical therapy aide and occupational therapy 



treatment plan is to b e e xpand e d and finaliz e d within -44 
days of admi s sion. Through an interdisciplinary proces s tho 



aido, with appropriate supervision, shall bo treatment plan shall bo reviewed at least monthly and 



oombin e d to provid e one full tim e e quivalent 
position for oaoh 20 pati e nts. — A proportionat e 
number of hour s shall bo provided for a census 
loss than 20 patients- 



r e vis e d as appropriate. — In e x e cuting tho tr e atm e nt plan th e 
int e rd i sciplinary t e am ohall b e the major deoioion making 
body and shall determine tho goals, process, and time 
frames for accomplishment of each patient's program. 



-(3) Clinioal nutrition oorvioos shall bo provid e d by Diociplin e o to b e represented on th e t e am ohall b e m e d i cin e , 



a qualifi e d diotioian with two y e ars elin ieal- 
tmining and experience in nutrition. — Tho num 
bor of hours of clinical nutrition oorvioos on 
e ith e r a full tim e or part tim e e mployment or 
contract basis shall be ad e quate to moot tho 
needs of tho patients. — Each patient's nutrition 
needs shall bo reviewed at least monthly. — Clini 



nursing, clinioal pharmacy and all other disciplines d i rectly 
involved in tho patient's treatment or treatment plan. 

(c) Each patient's overall program shall be a s signed to an 
individually designat e d oao e manag e r. — Th e oas e manage r 
aoto ao th e coordinator for assign e d pati e nts. — Any profos 
sional staff member involved in a patient's oare may bo 
assigned this responsibility for one or more patients. 



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76 



PROPOSED RULES 



Professional staff may divide this responsibility for all 
patients OB th e unit in the boot manner to moot all pati e nts' 
noods for a coordinated, interdisciplinary approach to oar e . 
Tbo case managor shall bo responsible for; 

(4-) coordinating tho dovolopmont, implementation 

and p e riodio revi e w of the patient's tr e atm e nt 

(3) preparing a monthly summary of tho patient's 

progress; 
(3) cultivating — tho pati e nt'o participation — in th e 

program; 
(4) general supervision of tho pationt during tho 

course of treatment; 
(5) e valuating appropriatonooo of tho treatment plan 

in relation to tho attainm e nt of otnted goals; and 
(6) assuring that discharge decisions and arrange 

roonto for post discharge follow up arc properly 



— -(d) — For e aoh 20 pati e nto or fraotion th e r e of, d e dicated 

treatment facilities and equipmoDt shall bo provided as 

follows: 

(4) A combin e d th e rapy space oqual to or oxoooding 

600 square foot, ad e quat e ly e quipp e d and ar 
ranged to support each of the therapies; 

(3) Access to ono full reclining wheelchair per 

pati e nt. 

(3) Special phyGioal th e rapy and occupational thor 

apy equipment for use in fabricating positioning 
device s — for bods and wheelchairs — including 
splints, oastc, oushions, wodgoo, and bolsters. 

(4) There shall b e roll in bath faoiliti e o with a 

dressing area available to all patients which shall 
afford maximum privacy to tho pationt. 

Statutory Authority G.S. 13 IE- 104. 

. 1 109 SPECIAL NURSING REQUIREMENTS FOR 
BRAIN INJURY LONG-TERM CARE 

Direot oar e nursing p e roonn e l staffing ratios established in 
Section .0500 of this Subchapter shall not bo applied to 
nursing services — for patients who require brain injury 
long term oare, du e to th e ir more intensiv e maintenanc e and 
nursing needs. Th e minimum dir e ot oar e nursing staff shall 
bo 5.5 hours per pationt day, allocated on a por shift basis 
as tho facility chooses, to appropriately moot tho patients' 
n ee ds. — It iG also roquirod that rogardloGO of how low tho 
patient census, th e dir e ot care nursing staff shall not fall 
below a registered nur s e and a nurse aide I at any time 
during a 2 4 hour period. 

Statutory Authority G.S. 131E-104. 

.1130 ADMISSIONS TO THE HTV DESIGNATED 
UNIT 

If a faoility declin e s admission to a pationt known to have 
Human Immunodeficiency Virus disease, tho reasons for tho 
denial shall bo documented. 



Statutory Authority G.S. 131E-104. 

.1131 HIV DESIGNATED UNIT POLICES AND 
PROCEDURES 

— (a) In addition to Rule .0314 of this Subchapter, in units 
dedioatod — te — the — tr e atm e nt — of patiento — with — Human 
Immunodofioionoy Virus diooaoo, polici e s and proo e duroo 
specific to tho specialized needs of tho patiento served shall 

bo developed. At a minimum they shall include staff 

training and e ducation, and th e availability of consultation 
by a physioian with sp e cialized eduoation or knowl e dg e in 
tho management of Human Immunodoficioncy Virus disease, 
(b) Policies and procedures for infection control shall bo 
« — conformance with 29 CFR 1910 (Occupational Safety 
and H e alth Standards) whioh is incorporated by reforonoo 

including subsequent amendments. Emphasis shall be 

placed on compliance with 29 CFR 1910 1030 (Bloodboumo 
Pathog e ns). Copi e o of Titl e 29 Part 1910 may b e purchas e d 
from the Superintendent of Dooumonto, U.S. Gov e rnm e nt 
Printing Office, Washington, D.C. 20 4 02 for $38.00 or may 
bo purchased with a credit card by telephone to tho Govern 
m e nt Printing Offio e at (202) 7 8 3 323 8 . Inf e otion control 
s hall al s o b e in compliance with th e C e nter of Disease 
Control Guideline s as publi s hed by tho U.S. Department of 
Health and Human Sorvicoe, Public Health Sorvioo which is 
incorporated by ref e reno e including subs e quent aro e ndm eBter 
Copi e s may b e purohasod from th e National T e chnical 
Information Sorvioo, U.S. Department of Commerce, 52 8 5 
Port Royal Road, Springfield, Virginia, 22161 for $15.95. 

Statutory Authority G.S. 131E-104. 

.1132 PHYSICIAN SERVICES IN A HTV 
DESIGNATED UNIT 

In faciliti e s — with a Human Immunod e fioi e noy — Virus 
designated unit, tho facility shall insure that attending 
physicians have documented, pro arranged aooooo in person 
or by tel e phon e to a physioian with sp e cializ e d e duoation or 
knowledg e in th e management of Human Immunodofioionoy 
Virus Disoaoo. 

Statutory Authority G.S. 13 IE- 104. 

. 1 133 SPECIAL NURSING REQUTCEMENTS FOR 
A HTV DESIGNATED UNIT 

— (a) — Faoilitieo with a Human Immunodefioienoy Virus 
designated unit shall hav e a registered nurs e with specialized 
eduoation or knowledge in tho care of Human Immunodofi 
cioncy Virus disease. 

(b) Nursing p e roonn e l assign e d to th e Human ImmunG de- 
fioi e noy Virus unit shall b e r e gularly assign e d to th e unit. 
Rotations are acceptable to olloviato staff burnout or staffing 
emergencie s . 

Statutory Authority G.S. 13 IE- 104. 

.1134 SPECIALIZED STAFF EDUCATION FOR 
HTV DESIGNATED UNITS 



77 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



For facilitioo with a Human Immunodeficiency Virus 
dooignatod unit, an organized, dooumonted program of 
oduoation opooifio to th e cor e of pati e nts infected with th e 
Human Immunodeficiency Virus shall bo provided and 
include at a minimum: 
— (4) Human Immunodofioi e noy Virus and Acquir e d 

Immune Dofioi e noy Syndrom e diooaoo prooooooo; 
— (3) transmission modes, oauoos, and prevention of 

Human Immunodeficiency Virus; 
—(39 tr e atm e nt of Human Immunodofioienoy Virus and 

Aoquired Immune Dofioienoy Syndrom e ; 
— (4) psycho socio economic — needs — &f- — the — Human 

Immunodeficiency Virus and Acquired Immune 

Dofioienoy Syndrom e pati e nts; 

— (5} univ e rsal pr e cautions and infection oontrol; and 

— (6} policie s and procedures specific to the Human 

Immunodeficiency Virus designated unit. 

Statutory Authority G.S. 13 IE- 104. 

.1135 USE OF INVESTIGATIONAL DRUGS FOR 
HTV DESIGNATED UNITS 

— (a) The supervision and monitoring for th e administration 
of investigational drug s i s the r esponsibility of the pharma 
cist and a licensed registered nurse, acting pur s uant to the 
orders of a physioian duly authoriz e d to proscribe or 
dispense such drugs. — Responsibiliti e s shall includ e , but not 
bo limited to, the following! 

(4) insuring the provision of written guidelines for 

any inv e stigational drug or study ar e provided; 



(3) training and determination of staffs abilities 

regarding admini s tration — of drug s , — policies, 
proc e dures and r e gulations. 
(b) Th e pharmacist or physioian disp e nsing th e inv e stiga 

tional drug is to provide the facility with information 

regarding at least the following! 

(4) a copy of the protocol, includ i ng drug inform a- 

(2) a copy of the patient's informed consent; 

(3) drug storage; 



-(4) handling; 



(§} ftfiy — sp e oifio — pr e paration — and — administration 

instructions; 
(6) specific detail s for drug accountability, rosupply 

and r e turn of unus e d drug; and 
(7) a copy of the signed oonoont to participat e in th e 

study. 
—(e) — Lab e ling of investigational drugs shall bo in aocor 
danc e with writton guidelin es of protocol and State and 
f e d e ral r e quirements r e garding suoh drugs. — Proscription 
labels for inve s tigational drugs are to bo distinguishable 
from other label s by an appropriate legend, "Investigational 
Drug" or "For Investigational Us e Only". 

Statutory Authority G.S. 131E-104. 



.1136 ADDITIONAL SOCIAL WORK 

REQUHtEMENTS FOR HTV DESIGNATED 
UNITS 

In addition to the social work services specified in Rule 
.1307 of this Subchapter, — in facilities with a Human 
Immunod e fici e ncy Virus diooaoo designated — unit, th e oooial 
work e r shall provid e or arrang e for th e provision of spiri 
tual, pastoral and grief counseling and bereavement service s 
for patients and staff whore appropriate. — Support service s 
shall b e provided to r e sid e nt famili e s and significant others. 
Wh e r e n e o e ooary, coordination with tr e atm e nt s e rvic e s for 
substance — abuse, — legal — services — and other community 
re s ources s hall bo identified. 

Statutory Authority G.S. 13 IE- 104. 

.1150 DEFINITIONS 

Th e following definitions shall apply to inpatient rohabili 

tat i on faciliti e s or units only: 

— (4) "Case management" moans the coordination of 

services, for a given patient, between di s cipline s 
so that th e pati e nt may r e aoh optimal rehabilitation 
through th e jud i cious use of rooourooo. 

— (2) "Comprehensive, inpatient rehabilitation program" 

moans a program for the treatment of persons with 
functional limitations or ohronio disabling oondi 
tiono who hav e th e potential to achi e v e a signifi 
cant improvement in activities of daily living : — A 
comprehensive, rehabilitation program utilizes a 
ooordinated — and — integrated, — interdisciplinary 
approaoh, dir e ct e d by a physioian, to ass e ss 
patient needs and to provide treatment and ovalua 
tion of physical, — psycho s ocial — and cognitive 
d e ficits. 

— (3) "Inpati e nt rehabilitation faoility or unit" means a 

free standing facility or a unit (unit pertains to 
contiguous dedicated bods and space s ) within an 
e xisting lioonood health sorvioo faoility approv e d in 
accordanc e with G.S. 13 IE, Articl e 9 to es tablish 
inpatient, rehabilitation bods and to provide a 
comprehensive, inpatient rehabilitation program. 

— (4) "M e dioal consultations" moans consultations whioh 

th e rehabilitation physioian or th e att e nding physi 
cian determine are necessary to moot tho acute 
medical needs of the patient and do not include 
routin e modioal needs. 

— (5) "Occupational th e rapist" m e ans any individual 

licensed in tho State of North Carolina as an 
occupational — therapist in accordance with tho 
provisions of G.S. 9 0, Artiole 1 8 D. 

—(6) "Occupational — therapist — assistant" — m e ans — any 

individual licen s ed in tho State of North Carolina 
as an occupational therapist assistant in accordance - 
with the provisions of G.S. 9 0, Artiol e 1 8 D. 
"Psychologist" m e ans a p e rson lic e ns e d as a 
practicing psychologist in accordance with G.S. 
90, Article 1 8 A. 



-(74- 



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April 17, 1995 



78 



PROPOSED RULES 



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-tf4)- 



"Phyoiatri e t" means a licensed physician who has 
oomplotod a physioal m e dioin e and rehabilitation 
r e sid e ncy — training — program — approved — by — the 
Accroditing Council of Graduate Modioal Educa 
tion of tho American Osteopathic AsBociation. 
"Physical therapist" m e ans any p e rson lio e no e d in 
the State of North Carolina as a phyoioal th e rapist 
in accordance with tho provisions of G.S. 90, 
Article 18B. 



"Phyoioal th e rapist assistant" m e ans any p e rson 
lioono e d in th e State of North Carolina ao a phyoi 
cal therapist assistant in accordance with the 
provisions of G.S. 90 270.2 4 , Article 1 8 B. 
"Rooroationol th e rapist" moans a person o e rtifi e d 
by th e State of North Carolina Th e rap e utio R e ore 
ational Certification Board. 
"Rehabilitation nurse" moans a registered nurse 
licens e d in North Carolina, with training, e it hef 
aoad e mio or on th e job, in phyoioal rehabilitation 
nursing and at least one year experience in physi 
cal rehabilitation nursing, 
"Rehabilitation aide" means an unlio e no e d assistant 



who works und e r th e sup e rvision of a registered 
nuroo, lioonsod physioal therapist or occupational 
therapist — m — aeoordan ee — w+tb — tho appropriate 
occupational lio e nour e laws gov e rning his or h e r 
sup e rvisor and consistent with staffing r e quir e 
moots as sot forth in Rule .1157 of this Section. 
The rehabilitation aide shall bo listed on tho North 
Carolina Nurs e Aid e R e gistry and hav e roooivod 
additional staff training as list e d in Rul e . 1 15 8 of 
this Section. 
"Rehabilitation physician" moans a physiatrist or 



a phys i cian who io qualified, based on education, 
training and e xp e ri e nc e r e gardlooo of sp e cialty, of 
providing modioal caf e to rehabilitation patients. 

(15) "Social worke r " means a person certified by tho 

North Carolina C e rtification Board for Social 
Work in aooordano e with G.S. 90 B 3. 

(16) "Speech and language pathologist" moan s any 

person licensed in tho State of North Carolina as 
a opocoh and languag e pathologist in aooordano e 
with th e provisions of G.S. 90, Artiol e 22. 

Statutory Authority G.S. 13 IE- 104. 

.1151 PHYSICIAN REQUIREMENTS/INPATIENT 
REHABILITATION FACILITIES OR UNITS 

(a) — In a rehabilitation facility or unit a physician shall 
participate in th e provision and manag e m e nt of rehabilitation 
s e rvic e s and in tho provision of m e dical sorvioos. 

(b) — In a rehabilitation facility or unit a rehabilitation 
physician shall bo responsible for a pationt's intordisciplin 
ary tr e atm e nt plan. — Eaoh pati e nt's int e rdisciplinary tr e at 
ment plan shall be developed and impl e m e nt e d und e r th e 
supervision of a rehabilitation physician. 

(o) — Tho rehabilitation physician shall participate in tho 
pr e liminary assooomont within 4 8 hours of admission, 



prepare a plan of oaro and direct the noooooary frequency of 
contact based on th e m e dioal and rehabilitation needs of the 
pati e nt. — Th e fr e quenoy shall b e appropriat e to justify th e 
need for oomprohonsivo inpatient rehabilitation care. 

(d) An inpatient rehabilitation facility or unit's oontmot o r 
agre e m e nts with a rehabilitation phyoioian shall r e quire that 
th e rehabilitation physician shall participat e in individual 
case conferences or care planning sessions and shall roviow 
and 3ign discharge s ummaries and records. — When patients 
ar e to b e discharg e d to anoth e r health car e facility, th e 
discharging facility shall assure that th e pationt has boon 
provided with a discharge plan which incorporates post 
discharge continuity of care and services. When patients are 
to b e discharg e d to a r e sid e ntial s e tting, the faoility shall 
assure that the patient has boon provid e d with a discharge 
plan that incorpo r ate s tho utilization of oommunity r esources 
when available and when included in tho pationt's plan of 

( e ) — Th e int e nsity of phyoioian m e dioal aorviooo and th e 
frequency of regular contacts for medical care for tho 
pationt shall bo determined by tho pationt's pathophysiologic 



— (£) — Whor e th e attending physician of a pati e nt in an 
inpatient — r ehabilitation — facility — or unit orders medical 
consultations for tho pationt, such consultations shall bo 
provid e d by qualifi e d phyoioiano within 4 8 hours of th e 
phyoioian'o ord e r. — In ord e r to aohi e v e this result, th e 
contracts or agreements botwoon inpatient rehabilitation 
facilities or units and medical consultants shall require that 
such consultants render th e requested medioal consultation 
within 4 8 hours. 

(g) An inpatient rehabilitation facility or unit shall have 
a — written procedure for sotting tho qualifications of tho 
physicians rendering physioal rehabilitation oerviooo in th e 
faoility or unit. 

Statutory Authority G.S. 13 IE- 104. 

. 1 1 52 ADMISSION CRITERIA FOR INPATIENT 
REHABILITATION FACILITIES OR UNITS 

(a) Tho facility shall have written criteria for admission 
to th e inpati e nt rehabilitation facility or unit. — A descript i on 
of programs or sorvioes for sorooning the suitability of a 
givon pationt for placement shall bo available to staff and 
referral sources. 

(b) — For pati e nts found unsuitable for admission to th e 
inpatient rehabilitation — faoility or unit, there shall b e 
documentation of tho reasons. 

— fe) — Within 48 hours of admission a preliminary assess 
m e nt shall b e oomplotod by m e mb e rs of th e interdisciplinary 
t e am to insur e th e appropriateness of plac e m e nt and to 
identify the immediate needs of tho patient. 

(d) Patients admitted to an inpatient rehabilitation faoility 
or unit must b e abl e to tol e rate a minimum of thr ee hours of 
r e habilitation th e rapy, fiv e days a w ee k, inoluding at l e ast 

two of tho following rehabilitation services ; physioal 

thorapy, occupational thorapy or speech therapy. 

( e ) Patients admitted to an inpatient rehabilitation faoility 



♦ 



79 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



of unit must bo medically stable, have a prognosis indicating 
a progressively improv e d modioal condition and hav e th e 
potential for increased indep e nd e nc e . 

Statutory Authority G.S. 13 IE- 104. 

.1153 COMPREHENSIVE INPATIENT 

REHABILITATION EVALUATION 

(a) A comprehensive, inpatient rehabilitation evaluation Statutory Authority G.S. 13 IE- 104. 
i e r e quired for e aoh pati e nt admitted to an inpatient rehab i li 



needs of the patient and shall partic i pate in all team confe r ■ 
onoos oonoeming th e pati e nt' s progress toward th e aooom 
pliohment of specifi e d goals. — Any of th e prof e ss i onal staff 
involved in the patient's care may bo the designated case 
manager for one or more cases, or the director of nur s ing 
or oooial work e r may acc e pt the coordination r e sponsibil i ty 
for th e pati e nts. 



tation facility or unit. — At a minimum this e valuation shall 
include the reason for referral, a s ummary of the patient's 
clinical condition, functional strengths and limitations, and 



.1155 DISCHARGE CRITERIA FOR INPATIENT 
REHABILITATION FACILITIES OR 
UNITS 



indications for op e oifio s e rvic e s. — This e valuation shall b e (a) — Discharg e planning shall b e an int e gral part of the 



oompl e t e d within throe days, 
(b) Each patient shall bo evaluated by the interdisciplinary 



pati e nt's tr e atm e nt plan and shall b e gin upon admission to 
tho facility. — After established goals have boon reached, or 

team to determine the need for any of the following sor a determination has boon made that care in a los s intensive 

vio e o: — m e dical, — dietary, — occupational therapy, physical 

therapy, prosthetics and orthotics, psyohologioal assessment 



s e tting would b e appropriat e , or that furth e r progr e ss is 
unlik e ly, th e pati e nt shall b e discharged to an appropriate 



and therapy, therapeutic recreation, rehabilitation medicine, s otting. Other reasons for discharge may include an 



rehabilitation nursing, therapeutic counseling or social work, 
vocational r e habilitation e valuation and speech languag e 
pathology. 

Statutory Authority G.S. 131E-104. 

.1154 COMPREHENSIVE INPATIENT 

REHABILITATION INTERDISCIPLINARY 

TREAT/PLAN (c) — If a patient i s being referred to another facility for 

(a) Th e int e rdisciplinary tr e atm e nt t e am shall develop an further oar e , appropriat e documentation of th e pati e nt's 

individual treatment plan for eaoh pati e nt within s e v e n days ourr e nt status shall bo forward e d with th e pati e nt. — A formal 



inability or unwillingness of patient or family to cooperate 
with th e plann e d th e rapeutio program or m e dioal oomplioa 
tiono that pr e clud e a further intensiv e r e habilitativ e e ffort. 
Tho facility shall involve tho patient, family, staff members 
and referral sources in discharge planning ^ 
—(b) — Th e ease manager shall facilitat e th e discharge or 
transf e r proo e so in coordination with th e facility oooial 
workers. 



after admission. Tho plan shall include evaluation findings 
and information about tho following; 
(t) prior level of function; 






ourr e nt functional limitations; 
s pecific service needs; 



-(4) treatment, supports and adaptations to be pro 

vid e d; 
-(5) sp e cifi e d treatment goals; 



di s charge summary shall bo forwarded within 48 hours 
following discharge and shall include tho reason s for 
referral, — the — diagnosi s; — functional — limitation s; — s e rvic e s 
provid e d, th e results of servic e s, r e f e rral aotion rooomm e n 
dations and activities and procedures used by tho patient to 
maintain and improve functioning. 

Statutory Authority G.S. 131E-104. 

.1156 COMPREHENSIVE REHABDLITATION 
PERSONNEL ADMINISTRATION 



(6) disciplines respon s ible for implementation of 

separate parts of tho plan; and 

(?) anticipat e d tim e frames for th e aooomplishm eat- 

of sp e cified long t e rm and short term goals. (a) — The facility shall hav e qualified staff memb e r s , 

(b) Tho treatment plan s hall bo reviewed by tho intordi s ci consultants and contract personnel to provide son 1 iocs to tho 

plinary team at least every other week. — All members of tho patients admitted to tho inpatient rehabilitation facility or 
interdisciplinary team, or a repres e ntativ e of their discipline, unit- 
shall att e nd e aoh meeting. — Docum e ntation of e aoh r e vi e w (b) Personn e l shall b e e mploy e d or provid e d by oontrao 

tual agree men t in sufficient typos and number s to moot tho 
needs of all patients admitted for comprehen s ive rohabilita 

(o) Written agre e m e nts shall b e maintain e d by th e facility 
when services are provided by contract on an ongoing basis. 



shall include progress toward defined goals and identifier 
tion of any changes in tho treatment plan- 
Co) Th e treatm e nt plan shall inolud e provisions for all of 
th e o e rvioos identifi e d as needed for tho patient in tho 
comprehensive inpatient, rehabilitation evaluation completed 
in accordance with Rule .1153 of this Subchapter. 

—(d) — Eaoh pati e nt shall have a designat e d oaso managor Statutory Authority G.S. 131E-104. 
who is r e sponsibl e for the coordination of th e pati e nt's 
individualized treatment plan. — Tho oaso manager is rospon 
siblo for promoting tho program's responsiveness to tho 



.1157 COMPREHENSIVE INPATIENT 

REHABILITATION PROGRAM STAFFING 



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NORTH CAROLINA REGISTER 



April 17, 1995 



SO 



PROPOSED RULES 



REQS 

(a) Th e staff of tho inpati e nt r e habilitation fooility or unit 
ohall includ e at a minimum: 

(+) Tho inpatient rehabilitation facility or unit shall 

bo supervised by a rehabilitation nuroo. — The 
facility ohall identify th e nuroing okil l s n e c e ssary 
to moot tho needs of the rehabilitation pati e nts in 
tho unit and assign staff qualified to moot those 
needs. 

(3) Th e minimum nursing hours p e r pati e nt in th e 

r e habilitation unit ohall b e 5.5 nursing hours p e r 
patient day. At no time shall direct oaro nur s ing 
staff bo loos than two full time equiva l ents, one 
of whioh shall b e a r e gistered nurs e ; 

(3) Th e inpati e nt rehabilitation unit shall e mploy o r 

provide by contractual agreements sufficient 
therapists, lioonsod in North Carolina, to provide 
a minimum of thr ee hours of sp e cific (physical, 
occupational or spoooh) or oombin e d r e habilita 
tion therapy services por patient day. 

(4) Physical — therapy assistants and occupational 

thoropy assistants shall b e lio e no e d or c e rtifi e d 
and shall be oup e rvio e d on site by lioonsod 
phy s ical — therapists — o r lioonsod — occupational 
therapists. 

(5) R e habilitation — aid e s — shall — hav e — docum e nted 

training appropriate to tho ootiviti e s to be per 
formed and tho occupational licensure laws of 
his or hor suporvisor. Tho ovorall responsibility 
for th e on going sup e rvision and e valuation of 
th e r e habilitation aid e r e mains with th e r e gis 
torod nurse as identified in Subparagraph (a)(1) 
of this Rule. — Supervision by tho lioonsod physi 
oal therapist or by the occupational therapist is 
limited to that tim e wh e n th e th e rapist is on site 
and directing tho rehabilitation activ i ties of tho 

(6) Hours of sorvio e by the rehabilitation aide are 

count e d toward th e required nuroing hours wh e n 
tho aide is working under tho supervision of tho 
lioonsod nur s e. Hours of service by tho rehabili 
tation aid e ar e oount e d toward th e rapy hours 
during that tim e th e aide works und e r th e imm e- 
diate, on sito supervision of tho lioonsod physical 
th e rapist or occupational therapist. — Hours of 
s e rvic e shall not b e dually oount e d for both 
s e rvio e s. — Hours of sorvio e by r e habilitation 
aides in performing nurse aide duties in areas of 
tho facility other than tho rehabilitation unit shall 
not b e oount e d toward tho 5.5 hour minimum 
nursing requir e m e nts described for tho rohabili 
tation unit. 

(b) Additional personnel shall bo provided as required to 
moot tho needs of tho pati e nt, as d e fin e d in th e comprehen - 
siv e , inpati e nt rehabilitation e valuation. 

Statutory Authority G.S. 13 IE- 104. 



. 1 158 STAFF TRAINING FOR INPATIENT 

REHABILITATION FACILITIES OR UNIT 

— Prior to th e provision of oar e , all r e habilitation p e rsonn e l, 
excluding physicians, assigned to tho rehabilitation unit shall 
bo provided training or shall provide documentation of 
training that inoludoo at a minimum th e following: 

— (±) act i v e and passiv e rang e of motion; 

— (3) assistance with ambulation; 

— (3) transfers; 

— (4) maximizing functional ind e p e nd e nce: 

— (5) th e poyoho social — needs — of the — r e habilitation 

patient; 
—(6) tho increased safety risks of rehabilitation trainin g 

(including falls and the use of restraints); 

— (?} prop e r body moohanios; 

— (8) nutrition, — including dysphagia and rostorativo 

eating; 
— (9) communication with th e aphaoio — and hearing 

impair e d pati e nt; 

(10) behavior modification; 

(11) bowel and bladder training; and 

(12) skin oar e- 



Statutory Authority G.S. 131E-104. 

.1159 EQUIPMENT REQS/COMPREHENSIVE 

INPATIENT REHABILITATION PROGRAMS 

—(a) — Tho facility shall provide each discipline with tho 
necessary equipment and treatment methods to achieve tho 
short and long term goals sp e cifi e d in th e compr e h e nsiv e 
inpati e nt rehabilitation int e rdisciplinary treatm e nt plans for 
patients admitted to those facilities or units. 

(b) — Each patient' s need s fo r a standard wheelchair or a 
sp e cially d e sign e d wheelchair or additional d e vio e s to allow 
oaf e and ind e p e nd e nt mobility within th e facility shall be 

—(e) — Special physical thorapy and occupational therapy 
e quipm e nt for use in fabricating positioning do vices for bode 
and wheelchairs ohall b e provid e d, inoluding splints, oasts, 
cushions, wedges and bolster s . 

(d) Physical thorapy devices shall bo provided, including 
a mat table, parallel bars and sliding boards and s p e cial 
adaptiv e bathroom e quipment. 

Statutory Authority G.S. 13 IE- 104. 

.1160 PHYSICAL FACILITY REQS/INPATIENT 
REHABILITATION FACILITIES OR UNITS 

(a) Tho inpatient rehabilitation facility or unit shall bo in 
a designated area and ohall b e us e d for th e opocifio purpose 
of providing a compr e h e nsiv e , — inpatient — rehabilitation 
program. 

(b) Tho floor area of a single bedroom shall be sufficient 
for the pati e nt or th e staff to e asily transf e r th e pati e nt from 
th e b e d to a wboolohair and to man e uv e r a 1 8 d e gr ee turn 
with a wheelchair on at least one side of tho bod. 

(c) — The floor area of a multi bod bedroom shall be 
suffici e nt for th e pati e nt or th e staff to e asily transf e r th e 



I 



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NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



patient from the bod to a wheelchair and to maneuver a 
1 8 d e groo turn with a wheelchair b e tw ee n b e ds. 

(d) — Eaoh patient room chall moot th e following r e quir e 
mont s ! 

— m- 



include! 

— w- 



offio e opao e for otnff; 



-&h 



Maximum room capacity of no more than four 

pati e nts; 

Oporablo windows; 



-(3) offio e spao e for spoooh therapy e valuation and 

treatment; 
waiting space; 






training bathroom whioh inolud e o toil e t, lavatory 



(3} A nuroo call system dooignod to moot the special 

needs of rehabilitation patients; 
(4) In single and two bod rooms with private toilet 

room, the lavatory may b e looatod in th e toil e t 

room; 
(5) A wardrobe or closet for each patient which is 

whoolohair aooessibl e and arranged to allow th e 

patient to aoo e ss the contents; 
(6) A chest of drawers or built in drawer s torage 

with mirror above, which is wheelchair acoossi 

bl e ; and 
(7) A bedside table for toil e t artiol e s and p e rsonal 

— (o) Space fo r emergency oqu i pmont such as resuscitation 
oarts shall be provid e d and shall b e under direct control of 
th e nursing staff, in proximity to th e nur se ' s s tation and out 
of traffic. 



and bathtub; 
-(#) gymnasium or exorcise area; 



-(&- 



work area such as tables or counters suitable for 



■W- 



wh ee lchair aoo e so; 

tr e atm e nt areas with available privacy ourtaino 
or s creen s ; 
( 8 ) an activities of daily living training kitchen with 
sink, cooking top (s c our e d wh e n not sup e rvised 
by staff), refrigerator and counter surface for 
moa l — preparation; 
— (9) s torage for clean linens, supplie s and oquipmont; 

(10) janitor's olos e t aooossiblo to the th e rapy ar e a 

with floor r e o e ptor or s e rvic e sink and storag e 
space for housekeeping supplies and oquipmont, 
one closet or s pace may servo more than one 
area of th e inpatient rehabilitation facility or 
unit; and 

(11) hand washing facilities. 



-(f) — Pationts' bathing facilities s hall moot the following — (+) — For social work and psychological services the 



sp e oifioationo: 

ft) Th e r e shall bo at least on e shower stall or on e 

bathtub for each 15 bods not individually served. 
Each tub or shower shall be in an individual 
room or privacy e nclosure whioh provid e s spac e 
for th e private u se of the bathing fixtur e , for 
drying and dressing and for a wheelchair and an 
assisting attendant. 

(3) Showers in c e ntral bathing facilities shall b e at 

l e ast fiv e foot squar e without ourbo and d e sign e d 
to permit use by a wheelchair patient. 

(3) At least one five foot by seven foot shower shall 

b e provid e d whioh oan accommodat e a str e tch e r 
and an assisting attendant. 
(g) — Patients' toilet rooms and lavatories shall moot the 

following specificat i ons: 

(4) Th e size of toilets shall permit a wh ee lohair, a 

s taff p e rson and appropriat e — wheel to water 
closet transfers. 

(3) A lavatory in the room s hall pormit whoolohair 



following shall b e provid e d: 

(4) offio e spao e for staff; 

(3) office space for private interviewing and coun 

soling for all family members; and 
(5) workspao e for t e sting, evaluation and oounsel 

iagr 
(j) If prosthetics and orthotic s service s are provided, the 
following space s hall bo made available as necessary! 

(4) work spao e for t e chnician; and 

(3) spao e for e valuation and fittings (with provisions 

for privacy), 
(k) — If vocational therapy s ervices are provided, the 
following s pao e shall b e mad e availabl e as n e o e soory: 



-(4} offio e spao e for staff; 

-(3) workspace for vocational sorvioos activities s uch 

as provocational and vocational evaluation; 
-(£) training spaoo 



storag e for e quipm e nt; and 



■&h 



ponru t- 
aoo e ss. 
Lavatori e s s e rving pati e nts shall: 



{§) coun s eling and placement space. 

(1) Recreational therapy spaoo requirements include the 
following: 
(4) activities spao e ; 



-(A) — allow wheelchairs to extend under the lavatory; 



(2) storage for oquipmont and supplies; 
-(3) office space for staff; and 



(B) — hav e water supply spout mount e d so that its 

discharge point is a minimum of five inohos 
above the rim of the fixture 

(4) Lavatories used by pationts and by staff shall bo 

e quipp e d with blad e operated supply valv e s, 
(h) Th e spaoo provid e d for physical th e rapy, oooupational 
therapy and spooch thorapy by all inpatient rehabilitation 
facilities or units may bo shared but mu s t, at a minimum, 



-(4>- 



aoo e ss to mal e and f e mal e toilets. 



(m) Th e following spao e shall b e provided for pati e nt's 
dining, recreation and day areas: 

(4) s ufficient room for whoolohair movemont and 

whoolohair dining s e ating; 



-m- 



if food s e rvioe is cafeteria typ e , ad e quat e width 
for wheelchair maneuvers, quouo spaoo within 
tho dining area (and not in a corridor) and a 



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82 



PROPOSED RULES 



serving counter low enough to view food; 

£i) total spaoo for inpationto, a minimum of 25 

square foot per bod; 

(4) for outpatients participating in a day program or 

partial day program, 20 square foot when dining 
io a part of the program and 10 square feet when 
dining is not a part of the program; and 

(5) storage for rocroational equipment and supplies, 

tables and chairs. 
—(b) — The pationt dining, roor e ation and day area spaooo 
shall bo provided with windows that hav e glazing of an ar e a 
not loss than eight percent of the floor area of the space, at 
least one half of the required window area must bo operable, 
(o) — A laundry shall b e availabl e and aoo e ssibl e — for 
pati e nts. 

Statutory Authority G.S. 13 IE- 104. 

.1161 ADDITIONAL REQUIREMENTS FOR 

TRAUMATIC BRAIN INJURY PATD2NTS 

Inpatient rehabilitation facilitie s providing services to 

poroono with traumatica brain injuries shall moot the requir e 

meats in this Rule in addition to those identifi e d in this 

Section. 

— (4) Direct care — nursing — personnel — stuffing — ratios 

establish e d in Rul e . 1 157 of this S e otion shall not 
be appli e d to nursing s e rvio e s for traumatic brain 
injury patients in the inpatient, — rehabilitation 
facility or unit. — The minimum nursing hours per 
traumatic brain injury pati e nt in th e unit shall b e 
6.5 nursing hours p e r pationt day. — At no tim e 
shall direct care nursing s taff bo loss than two 
full time equivalents, one of which shall bo a 
r e gist e r e d nurs e . 

— (2) The inpatient r e habilitation faoility or unit shall 

employ or provide by contractual agreements 
physical, occupational or s peech therapists in 
ord e r to provide a minimum of 1.5 hours of 
specific or oombin e d r e habilitation therapy s e r 
vices per traumatic brain injury pationt day. 

— (3) The facility shall provide special faoility or equip 

m e nt needs for pati e nts with traumatic brain 
injury, inoluding a qui e t room for therapy, sp e 
cially designed wheelchairs and standing tables. 

— (4) The medical director of an inpatient traumatic 

brain injury program shall hav e two years man 
ag e m e nt in a brain injury program, on e of whioh 
may bo in a clinical fellowship program and board 
eligibility or certification in tho medical specialty 
of th e physician's training. 

— (5) Th e faoility shall provid e th e consulting oorvioeo 

of a neuropsychologist. 

— (6) The faci l ity shall provide continuing education in 

th e oar e and treatm e nt of brain injury pati e nts for 
all staff. 

— (7) The size of tho brain injury program shall bo 

adequate to support a oomprohonsivo, dodioatod 
ongoing brain injury program. 



Statutory Authority G.S. 131E-104. 

. 1 162 ADDITIONAL REQUIREMENTS FOR 
SPINAL CORD INJURY PATIENTS 

Inpatient rehabilitation facilities providing services to 

p e rsons with spinal cord injuries shall moot th e r e quir e m e nts 

in this Rule in addition to thos e id e ntified in this Section . 

— (4) Direct oare — nursing — personnel — staffing — ratios 

established in Rule . 1 157 of thi s Section shall not 
b e appli e d to nursing sorvioos for spinal oord 
injury patients in th e inpati e nt) — rehabilitation 
facility or unit. — Tho minimum nursing hours per 
spinal oord injury pationt in tho unit shall be 6.0 
nursing hours p e r pati e nt day. — At no tim e shall 
dir e ct oar e nursing staff bo looo than two full tim e 
equivalents, one of whioh shall be a registered 
nurs e . 

—(2) Th e inpati e nt r e habilitation faoility or unit shall 

employ or provid e by contractual agr ee m e nts 
physical, occupational or s peech therapi s ts in 
order to provide a minimum of 4 .0 hours of 
sp e oifio or oombin e d r e habilitation th e rapy s e r 
vices per spinal oord injury pati e nt day. 

—(3) The facility s hall provide special faoility or special 

equipment needs of patients with spinal oord 
injury, inoluding specially d e signed whoolohairo, 
tilt tables and standing tabl e s. 

— (4) Tho medical director of an inpatient spinal oord 

injury program shall have either two years expori 
e no e in th e m e dioal oar e of p e rsons with spinal 
oord injuri e o or six month's minimum in a spinal 
cord injury fellowship. 

—(5) Tho facility shall provide continuing education in 

th e oar e and tr e atm e nt of spinal oord injur)' pa 
tionts for all staff. 

— (6) Tho facility shall provide s pecific s taff training 

and education in tho oare and treatment of spinal 
oord injury. 

— (7) The siz e of th e spinal oord injury program shall b e 

adequate to support a oomprohonsivo, dedicated 
ongoing s pinal oord injury program. 

Statutory Authority G.S. 13 IE- 104. 

. 1 163 DEEMED STATUS FOR INPATIENT 

REHABILITATION FACILITIES OR UNITS 

(a) — If an inpatient rehabilitation facility or unit with a 
comprehensive inpatient rehabilitation program is surveyed 
and accredited by tho Joint Commission for tho Aooredita 
tion of H e alth Care Organizations (JCAHO) or th e Comm w- 
sion on Accr e ditation of R e habilitation Facilities (CARF), 
and has boon approved by tho Department in aooordano e- 
with G.S. 13 IE, Article 9 , the department dooms tho faoility 
to bo in oompliano e with Rul e s .1150 through .1160 and 
. 1 163 of this Section. 

(b) Doomed status shall be provided only if tho inpatient 
rehabilitation faoility or unit providos oopios of survey 
reports to th e Division. Th e JCAHO report shall show that 



♦ 



83 



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April 17, 1995 



10:2 



PROPOSED RULES 



the facility or unit was s urveyed for rehabilitation services. 
Th e CARF r e port shall ohow that th e faoility or unit was 
surv e y e d for oomprehenoiv e r e habilitation services. — % 
facility or unit shall sign an agreement (Memorandum of 
Understanding) specifying those terms. 

(o) — Th e inpatient rehabilitation faoility or unit shall b e 
subject to insp e ctions or oomplaint inv e stigations by ropre 
sontativos of the Department at any time. — If the facility or 
unit i s found not to bo in compliance with the rules listed in 
Paragraph (a) of this Rule, the faoility shall submit a plan of 
corr e ction and be subjoot to a follow up visit to assur e 
compliance. 

(d) If the inpatient rehabilitation facility or unit lose s or 
does not ren e w its accr e ditation, th e facility or unit shall 
notify' the Division in writing within 30 days. - 

Statutory Authority G.S. 131E-104. 

SECTION .1200 - ACTIVITIES AND 
RECREATION 

.1204 DESIGNATED PERSON 

Th e faoility administrator shall d e signat e an activities and 
recreation services director who shall bo under the ad mini s 
trativo supervision of the administrator, bo responsible for 
th e activiti e s and r e or e ation sorviooo for all pati e nts and who 
shall hav e appropriate manag e m e nt authority. — Any dir e otor 
hired on or after the effective amended date of this Rule 
shall bo a qualified professional who! 

— (4) Is a th e rap e utio r e oreation s p e cialist or th e rap e utic 

r e or e ation assistant o e rtified by the North Carolina 
State Board of Therapeutic Recreation Cortifica 
tion pur s uant to G.S. 90C 9 or is oligiblo for 
c e rtification as a thorapoutio r e or e ation specialist 
by a rooogniz e d — aoor e diting body; or 

— (2) Has two years of oxporionco in a social or rooro 

ation program within the lost five years, one of 
which was full tim e in a resident activiti e s pro 
gram in a h e alth oare setting; or 

— (?) Is a qualified occupational therapist or occupa 

tional therapy assistant licensed a s ouch by the 
North Carolina Board of Occupational Therapy 
pursuant to G.S. 90 270.70; or 

—(4) Is oertified by the National Certification Council 

for Activity Professionals; or 

(5) Has oomplotod an aotivities training oouro e ap 

proved by th e State. 

Authority G.S. 131E-104; 143B-1 65(10); 42 U.S.C. 1396; 
42 C.F.R. 483.15(f). 



.1206 ACTIVITY PROGRAM: GOALS AND SCOPE 

(a) — Restoration to self oar e and r e sumption of normal 
activity shall bo one of the main goals of the recreation or 
activity' program, 
(b) Th e soop e of th e aotivity program shall includ e : 
(1) oooial aotiviti e s involving individual and group 
participation which are designed to promote 
group relationships; 

(3) r e oreational aotiviti e s, both indoor and outdoor; 

(?) opportunity to participat e in aotivities outside the 

facility; 

(4) assisting patients and residents exorcise thoir 

right to attend church and religious programs of 
th e ir ohoio e ; 

(#) creative and expressive activities; 

(6) educational activities; and 



-O- 



e x e rois e . 



Statutory Authority G.S. 131E-104. 

.1207 POLICIES AND PROCEDURES 

Th e faoility shall have writton polioi e s and procedures 
which ore available and implemented by staff that: 

— (4) attempt to prevent the further mental or physical 

d e terioration for thos e pati e nts or residents who 
cannot r e alistically r e sume normal aotiviti e s; 

— (3) assure opportunities for patient involvement, both 

individual and group, in both planning and imple - 
menting th e aotivity program; 

— (?) provid e patients or residents th e opportunity for 

choice among a variety of activities; and 

— (4) encourage participation by each patient or resident 

in social and recreational aotiviti e s according to 
individual need and abiliti e s and dosires unless the 
patient's or resident's record contains documenta 
tion that ho is unable to participate. 

Statutory Authority G.S. 131E-104. 

.1208 DOCUMENTATION 

(a) — Eaoh pati e nt's or r e sid e nt's aotivity plan shall b e a 
part of his overall plan of oare and shall contain documenta 
tion of periodic assessments of the individual's activity 
needs and intere s ts. — A record of activities and individuals 
participating shall bo maintain e d in th e faoility. 

(b) — A licensed faoility shall display a monthly aotiviti e s 
calendar which includes a variety to appeal to different 
interest groups in all lovols of care for which the faoility is 
licensed. 



.1205 RESOURCES 

The facility shall maintain and make available a listing of 
looal resouro e o for aotiviti e s and reor e ation to bo utilized in 
mooting the needs and inter e sts of all pati e nto and r e sidents. 

Statutory Authority G.S. 13 IE- 104. 



Statutory Authority G.S. 13 IE- 104. 

.1210 SUPPLIES AND EQUIPMENT 

There shall bo e quipment and suppli e s suffici e nt to oarry 
out planned programs for both individual and group activi 



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84 



PROPOSED RULES 



Statutory Authority G.S. 13 IE- 104. 

SECTION .1300 - SOCIAL SERVICES 

.1306 DESIGNATED PERSON 

Th e Adminiotrator ohall dooignat e an e mployee to bo 
rooponoiblo for the provioion of oooial oorviooo who ohall b e 
known as the Social Services Director, — Sub s equent to the 
effective date of the rules contained in this Subchapter - any 
newly designat e d p e roon must b e a graduat e of a four y e ar 
coll e g e or univ e rsity with one y e ar'o e xp e ri e nc e in th e 
health care or long term care field or have an equivalent 
combination of education and experience. — An equivalent 
combination of e ducation and experi e nc e m e ano th e numb e r 
of years of e ducation l e ading to a baooalaureate or associat e 
degree plus the number of years of long term nursing 
facility experience equal to five years; or elig i ble for 
c e rt i fication ac a social worker pursuant to G.S. 90B 7. 
Th e Social S e rvices Dir e otor ohall hav e authority to oarry 
out provisions contained in Rule .1307 of thi s Section. 

Statutory Authority G.S. 131E-104. 

. 1307 PLAN OF SERVICES 

(a) Each patient's or resident's plan of care shall contain 
a writt e n plan for mooting hio individual soc i al n ee ds and 
involving hie activ e partic i pation. 

(b) — The plan shall provide for needed assistance in 
mooting the patient's or resident' s phys i cal, social and 
e motional noodo through consultation with the patient or 
r e sid e nt, l e gal guardian or hio r e lative, physician and/or 
others. 

— (e) — The plan shall provide for assisting the patient or 
resident in adjusting to his e nvironm e nt, for r e ferral to other 
supporting r e oouro e o, for protectiv e o e rvio e a, for financial 
services and for assistance at the time of discharge or 
transfer into a now environment. 

(d) Th e plan shall provid e for th e utilization of cas e work 
e re e mployed by the county Department of oooial s e rvices in 
the case of recipients of public assistance and for the 
utilization of appropriate persons with experience and 
training in the gonoral area of oooial work in th e ease of 
those not on publio aooiotano e . 

Statutory Authority G.S. 131E-104. 

.1308 DISCHARGE PLANNING 

(a) — Discharge planning s hall be in keeping with each 
patient's and re s ident' s post discharge needs. 

(b) — Th e Adminiotrator ohall aoour e that a medical order 
for diooharg e including any sp e cial inotruotiono for m e eting 
rehabilitation potential i s obtained for all patients o r roei 
dents except when a patient or resident loave s again s t a 
phyoioian'o order or advio e . 

(o) — Th e Social S e rvioeo Dirootor shall ooordinato die 
charge inotructions and assure that patients and residents and 
their familie s are instructed in accordance with discharge 
orders. 



Statutory Authority G.S. 13 IE- 104. 

SECTION .1400 - SPECIAL REQUIREMENTS 

.1405 EMERGENCY PROCEDURES 

(a) Each e mploy ee providing d i r e ct patient oare ohall be 
train e d in at l e ast th e following: 

(4) use of emergency equipment such as oxygon and 

suction apparatus*, 

(3) proc e dur e to follow with ohoking viotimo; a nd 

(3) proc e dure to follow in oummoning aooiotanoe 

required for emergency r escue, law enforcement 

or protection and fire. 
(b) — P e rsonn e l fil e o for patient oare employooo must 
contain — docum e ntation — te — r e fl e ct — that employooo — hav e 
successfully completed training in the areas described in 
Paragraph (a) of this Rule. 

Statutory Authority G.S. 13 IE- 104. 

.1406 REPORTABLE DISEASE 

All oas e s of reportabl e dio e ao e as required by the Comm ie- 
aion for H e alth S e rvio e o (10 NCAC 7A .0100) and e pidomio 
outbreaks, and poisonings shall bo reported immediately to 
the local Health Director and the Department. 

Statutory Authority G.S. 13 IE- 104. 

.1408 RESTRAINTS 

— (a) — Patients and rooidento ohall bo restrained only oo 
provid e d for in D e claration of Patients' Righto, G. S . 
13 IE 117(6) and in accordance with policies implemented 
pursuant to Rule .0505(f). 

(b) In emergency s ituations e ith e r th e nurs e in charg e or 
a r e gister e d nurs e in a high e r supervisory position, ohall b e 
responsible for making the determination r elative to noeo s 
sity for the typo and duration of phy s ical restraint to use 
whil e contacting a physician. 

(o) Th e typo of restraint used and the time of application 
and removal ohall bo recorded by a licensed nurse in the 
patient's or resident's record. 

Statutory Authority G.S. 131E-104. 

.1409 REPORT OF DEATH 

A lioenood fdoility shall have a written plan to b e follow e d 
wh e n a patient dies. The plan muot provid e for th e follow 

—(4) collection of data needed for death certificate a s 

r e quir e d by G.S. 130A 117; 
— (3) record i ng tim e of d e ath; 

-&r 



-w 



pronouncement of death by a phys i cian or medical 

examiner; 

notification of att e nding physician r e sponsibl e for 

signing d e ath o e rtifieato if different from physician 

pronouncing death; 

■(§) notification of next of kin or legal guardian if one 

has boon appointed; 



♦ 



85 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



-(6) authorization arid release of body to funeral homo; 



-&- 



notification to th e D e partment of any death rooult 
ing from on injury, accident or other possible 
unnatural causes. 



Statutory Authority G.S. 131E-104. 

.1410 PETS (COMPANION ANIMALS) 

(a) No animal ohall be brought into th e facility e xo e pt in 
aooordanoe with Paragraph (b) of this Rul e . 

(b) A patient's or resident's personal pot may bo brought 
into the facility for a short visit under tho following condi 
tions: 

(4) th e facility's polio ie o and prooedur e o p e rmit p e t 

visitation and tho policies are followed during 

tho visit; 
(2) boforo a dog or oat may e nt e r th e faoility, proof 

of immunization against rabies ohall b e oubmit 

t od to tho Administrator; and 
(3) pots shall not bo permitted in areas whore food 

or drink is pr e par e d or s e rv e d. 

Statutory Authority G.S. 131E-104. 
SECTION .1500 - DESIGN AND CONSTRUCTION 

.1501 GENERAL RULES 

(a) — Each facility must bo planned, constructed, and 
e quipp e d to provid e th e s e rviooo offered to b e p e rformed in 
th e faoility. 

(b) Any existing building converted to a nursing homo or 
related facility shall moot all requ i rements of a now facility. 

(o) — The sanitation, wat e r s upply, sewag e disposal, and 
di e tary faoiliti e o must oomply with th e rules of the Commio 
sion fof Health Services. 

—(d) — The domiciliary home portion of a combination 
faoility must moot th e rules for a nursing faoility oontain e d 
in S e ctions .1500, .1600, .1700 and .1 8 00 of this Subohap 
tor, except when separated by a two hour fire resistive 
construction. — In this ease, tho domiciliary home portion 
must moot tho ruloo for domioiliary homes, 10 NCAC 42D, 
and supporting ar e as must b e looated in tho same area of tho 
facility as tho domiciliary homo portion. 

Authority G.S. 13 IE- 104; 42 U.S.C. 1396. 

.1502 SITE 

Tho site of tho proposed facility must bo approved by tho 
D e partment prior to oonotruotion and ohall: 

— (i) bo aoooooiblo by publio road s and publio tranopor 

tation; 

(2) bo accessible to fire fighting services; 

— (3) bo provid e d with an approv e d water supply, 

sewages disposal syst e m, garbag e disposal syst e m 
and trash disposal system; 
— (4) moot all local ordinances and zoning laws; and 



— (5) bo free from exposure to hazards and pollutants. 

Statutory Authority G.S. 131E-104. 

.1503 PLANS AND SPECOTCATIONS 

— (a) — When oonotruotion or remodeling io plann e d, fina l 
working drawings and op e oifioations muot b e submitted by 
tho owner or his appointed roprooontativo to tho Department 
for review and approval. — Schematic drawings and prolimi 
nary working drawings shall be submitted by tho owner 
prior to th e required submission of final working drawings. 
Tho Department will forward copie s of each submittal to tho 
Departm e nt of Insurance and Division of Health Services for 
r e vi e w and approval. — Three oopi e s of th e plans ohall b e 
provid e d at e aoh submitta l- 

(b) Approval of final plan s and sp e cification shall expire 
one year from tho date granted unless a contract for tho 
oonstruotion has boon s i gn e d prior to th e e xpiration dat e . 
—(e) — If on approval e xpires, a renewed approval shall b e 
i s sued provided revised plans mooting all current rogula 
tions, codes, and standard s are s ubmitted. 

(d) Compl e ted oonotruotion muot conform to the minimum 
standards e stablish e d in Sections .1500, .1600, .1700 and 
. 1 8 00 of this Subchapter. — Prior to approval for licensure, 
one sot of "as built working drawings" must bo furni s hed to 
th e Department. 

( e ) — Th e own e r or his designated agent shall notify th e 
Department when actual construction starts and at points 
when construction is 50 percent, 75 percent, and 90 percent 
of completion and upon final compl e tion, so that p e riodio 
and final insp e ctions oan b e performed. 
—(I) — Tho owner or his designated agent shall submit for 
approval by tho Department all alterations or remodeling 
ohong es whioh aff e ot th e otruotural integrity of th e building, 
functional op e ration, fir e saf e ty or whioh add b e ds or 
facilities over those for which tho facility is licensed. 

Statutory Authority G.S. 13 IE- 104. 

SECTION .1600 - FUNCTIONAL 
REQUKEMENTS 

.1612 REQWRED SPACES 

—(») — The floor area of a single bedroom shall not bo loss 
than 100 square foot and tho floor area of a room for more 
than 1 b e d shall not bo less than 8 square foot per bod. 
Th e 8 squar e f ee t and 100 square foot r e quirements shall 
bo exclusive of closets, toilet rooms, vestibules or ward 
robes : — When a designated sing l e room exceeds 159 square 
foot floor ar e a, it ohall remain a singl e b e droom and cannot 
b e us e d as a multi bedroom at any futur e date. 

(b) — Tho total space sot aside for dining, recreation and 
other common uses shall not bo loss than 25 square foot per 
b e d for a nursing faoility and 30 square foot per bod for a 

domioiliary hom e . Physical therapy and occupational 

therapy space shall not bo included in thi s total; 

(1) In now nursing homos divorsional activity and 



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86 



PROPOSED RULES 



therapeutic rocroation areas shall bo provided 
soparato from the main living and dining ar e as. 

(3) Dining, rooroation and other common use ar e as 

shall bo designed and equipped to provide acooo 
sibility to both wheel chair and ambulatory 
pati e nto. 

(3} Rooroation and other oommon uo e aroao shall be 

designed for independent and group activity use. 

(4) Closets and other storage areas for equipment 

and ouppli e o shall not b e Includ e d in the required 
dining, rooroation and oommon uo e floor opao e 

(£) Handicap accessible outdoor areas for individual 

and group aotiviti e o shall bo provid e d. 
— («} — A toil e t room ohall bo dirootly aoo e ooiblo from e aoh 
patient room and from oaoh central bathing area without 
going through the general corridor. — One toilet room may 
sorvo two pati e nt rooms but not mor e than e ight b e ds. — The 
lavatory may b e omitt e d from th e toil e t room if on e io 
provided in each patient room. — One tub or shower shall bo 
provided for each 15 bods not individually sorvod. — There 
ohall b e at least on e bathtub aoooooibl e on throe s i des and 
one shower providod for oaoh 60 b e do or fraotion ther e of, 
(d) — For each nursing unit or fraction thereof on each 
floor, the following shall bo provided ; 

(+) a m e dication preparation area with oounter, sink 

with four inch hand loo, modioation r e frig e rator, 
oyo lovol medication storage, eabinet storage, 
and double locked narcotic storage room, located 
adjao e nt to the nursing station or under vioual 
oontrol of th e nursing station; 

(2) a clean utility room with counter, sink with 

four inch handles, wall and under counter stor 
sge, 

(3} a soil e d utility room with oounter, sink with 

four inch handles, wall and under oounter stor 
ago, a flush rim clinical sink or water closet 
with a d e vic e for cl e aning bedpans and a m e ans 
for washing and sanitizing b e dpano and other 
utensils; 

(4) a nurses' toilet and locker space for coats, 

purses, oto.; 

(5) an audiovisual nuroo patient call syst e m arrang e d 

to ensure that a patient's call in the facility is 
noted at a staffed station; 
(6) a soil e d lin e n storag e room ohall bo provided; 



f?) a clean linen s torage room shall be provided. 

(o) — Clean linen storage shall bo providod in a s eparate 
room for bulk oupplieo. — Cl e an lin e n for nursing units may 
b e stor e d in oloo e d carte or oabin e ts in the oloan utility room 
or in a linen clo s et on the unit floor. 

(f) A soiled linen room shall bo provided. 

(g) Eaoh nursing unit ohall b e provid e d with at l e ast on e 
janitor's olooot. — D ie tary and laundry oaoh must have a 
janitor's closet. Administration, occupational and physical 
therapy, recreation, personal oaro, and employee facilities 
shall bo providod janitor's olooeto and may shar e on e as a 



group. 

(h) Str e toh e r and wheelchair storage ohall bo providod. 
— (i) — Bulk storag e shall b e provided at th e rate of five 
square foot of floor area per bed. 

(j) Office space must bo providod for persons holding the 
following positions: Administrator, Dir e ctor of Nursing, 
Social Servio e s Director. Activities and R e creation Dir e ctor, 
and Physical Therapi s t, if offered. — There must also be a 
business office. 

Authority G.S. 131E-104; 42 U.S.C. 1396. 

.1613 FURNISHINGS 

(a) — Handgrips shall bo providod for all toil e t and bath 

faciliti e s used by patiento. — Handrails shall bo providod on 

both side s of all corridors used by patients. 
(b) — For each nursing unit or fraotion thereof on each 

floor, th e following ohall b e provid e d: 

(4-) a nourishment station with work space, cabinet, 

and refrigerated storage, a small stove or hot 
plate in an area physically separated from the 
nurses' station; 

(3) one nurses' station consisting of d e sk opao e for 

writing, storage space for office supplie s and 
storage space for patients' records. 

— (e) — Flam e proof privacy scr ee ns or ourtaino ohall b e 

provid e d in multi b e dd e d rooms. 

Statutory Authority G.S. 131E-104. 

SECTION .1700 - FIRE AND SAFETY 
REQUIREMENTS 

.1703 NEW FACILrTY REQUIREMENTS 

A now facility ohall moot tho requir e m e nts of th e curr e nt 
North Carolina State Building Code and the following 
additional r equirements: 
— (4-) Eaoh floor uo e d for s l ee ping patients shall b e 

divid e d into at least two sections by a smok e 

barrier. 
— (3) Whore nursing units are located on tho same floor 

with oth e r D e partm e nts or servio e s, th e faoility 

ohall b e d e sign e d to provide separation from th e 

other Departments or s ervices with a smoke 

barrier. 
— (3) Horizontal e xits ar e not p e rmitted in any now 

faoility. 

Statutory Authority G.S. 131E-104. 

.1704 ADDITIONS 

An addition to an existing facility shall meet tho same 
requirements as a now facility except that in no case shall 
mor e than one horizontal e xit b e uo e d to r e plac e a r e quir e d 
e xit to th e outsid e . 

Statutory Authority G.S. 13 IE- 104. 



87 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



SECTION .1800 



MECHANICAL: ELECTRICAL: 
PLUMBING 



.1804 HEATING AND AIR CONDITIONING 

Heating and cooling systems shall moot the current 
Amerioan — Sooi e ty — of Heating, — R e frig e ration, — and Air 
Conditioning Engin ee rs Guide and National Fire Prot e ction 
Association Code 90 A (1 9 73 edition) with the following 
modifications! 
— fl-) Soiled lin e n, bathroomo, janitor olos e te and soil e d 

utility rooms must hav e negative pr e ssur e with 

relationship to adjacent areas. 
— (3) Clean linen, clean utility and drug rooms must 

hav e positive prooour e with relationship to adjac e nt 



— (3) All areas not covered in (1) and (2) of this Rule 

must have neutral pressure. 

Statutory Authority G.S. 13 IE- 104. 

.1805 EMERGENCY ELECTRICAL SERVICE 

Em e rg e noy e l e otrioal oorvio e s hall b e provided for use in 
th e e v e nt of failur e of th e normal e l e ctrical service. — This 
omorgoncy service shall be made up as follows: 

— (+) In any oxisting facility, the following must bo 

provid e d: 

(a) typ e 1 or 2 e m e rg e noy lights as r e quir e d by th e 

North Carolina State Building Code; 

(b) additional — omorgoncy — lights for all nursing 

stations, drug preparation and storag e ar e as, and 
for the telephone switohboord, if applicabl e ; 

(e) one or more portable battery powered lamp s at 

each nursing station; and 

(d) a — suitable — sewee — of e m e rg e noy — pow e r for 

lif e sustaining e quipm e nt, if th e home admits or 
cares for occupants needing suoh equipment, to 
e nsure continuous operation for a minimum of 
72 hours. 

— (3) Any addition to an e xisting faoility shall m e et the 

same requirements as now construction. 

— (3) Any conversion of an oxisting building (hotel, 

mot e l, abandon e d hospital, abandon e d school, 
e tc) shall moot the sam e r e quirements for emor 
goncy electrical — sorvicos as required for now 
construction. 

— (4} For now construction, an e mergenoy generating 

set, inoluding th e prim e mov e r and g e n e rator, 
shall bo located on the promises and shall bo 
reserved exclusively for s upplying the omorgoncy 
e l e otrioal system. 

— ($) Lighting for emerg e noy e l e otrioal servio e s shall b e 

provided in the following place s : 

(a) oxit ways and all nece s sary ways of approach 

th e r e to, inoluding exit signs and e xit dir e ction 
signs, e xterior of e xits, e xit doorway s , stair 
ways, and corridors; 
(b) dining and recreation room st 



— (e) nursing station and modioation preparation area; 

— (d} g e n e rator sot location, switoh g e ar location, and 

boil e r room (if applicable); and 

— (e) elevator (if required for emergency). 

-(6) Emergency equipment which is essential to life, 

saf e ty, and th e prot e ction of important e quipm e nt 
or vital mat e rials shall b e provid e d: 
nurses' calling system; 



-(a)- 



■<&■ 



-fe)- 



-m- 



-e- 



alarm system including fire alarm actuated at 
manual station s , wat e r flow alarm d e vio e s of 
sprinkl e r syst e ms if e l e otrioally operated, fir e 
detecting and smoke detecting s ystems, paging 
or speaker systems if intended for issuing in 
struotions during e m e rg e noy — conditions, and 
alarms r e quir e d for nonflammabl e medical gas 
systems, if installed; 
fire pump, if installed; 



-(e)- 

-(d} sew e rag e or sump lift pump, if installed; 

-(e)- 



on e e l e vator, — wher e — elevators — ar e us e d for 

vortical transportation of patients; 

equipment suoh as burners and pumps necessary 



for op e ration of on e or mor e boilers and thoir 
n e c e ssary auxiliari e s and controls, required for 
heating and sterilization, if installed; 
equipment necessary for maintaining telephone 
sorvioe; 

A minimum of on e d e dioat e d e m e rg e noy branch 
circuit per bod i s required for ventilator depend 
ont patients in addition to the normal sys tem 
r e o e ptaol e at e ach bed locat i on roquir e d by th e 

National — El e otrioal — Cod e . This e m e rg e noy 

circuit shall bo provided with a minimum of twe 
duplex receptacles identified for omorgoncy use- 
Additional e m e rg e noy branch oirouits/reooptaoles 
shall b e provid e d wh e r e th e e l e otrioal lif e sup 
port needs of the patient exceed the minim wn 
requirements stated in this Subparagraph. — Eaeh 
e m e rg e noy circuit serving ventilator d e p e nd e nt 
pati e nts shall b e f e d from th e automatically 
transferred critical branch of the essential olootri 
col system. — This Subparagraph shall apply to 
both n e w and e xisting facilities; 
H e ating — e quipment — provid e d — fe* — v e ntilator 
dependent patient bedrooms shall bo connec ted- 
to the critical branch of the essential electrical 
system and arranged for d e lay e d automatic or 
manual conn e ction to th e e m e rg e noy pow e r 
source if the heating equipment depends upon 
electricity for proper operation. — This Subpara 
graph shall apply to both n e w and e xisting 
faciliti e s; and 
Task lighting connected to the automatically 



-o- 



tmnsforrod critical branch of the essential oloctri 
oal system shall be provided for e aoh v e ntilator 
d e p e nd e nt pati e nt b e droom. — This Subparagraph 
shall apply to both now and oxisting facilities. 
Whore electricity is the only source of power 



10:2 



NORTH CAROLINA REGISTER 



April 17, 1995 



88 



PROPOSED RULES 



normally used for space heating, the emergency 
sorvio e shall provid e for heating of patient roomo. - 
Em e rg e noy h e ating of pati e nt rooms will not b e 
required in areas whore th e nursing homo is 
supplied — by — at — least — twe — separate — generating 
souro e o, or a network distribution system with th e 
nursing homo foodoro so routed, oonneot e d, and 
protected that a fault any place between the gonor 
ators and tho nursing homo will not likely cause 
an int e rruption. 

— (&) The e m e rg e noy — ele otrioal — system shall be so 

controlled that after interruption of tho normal 
electric power supply, tho generator is brought to 
full voltag e and fr e qu e ncy and oonn e ot e d within 
10 sooonds through one or mor e primary auto 
matic transfer sw i tches to all emergency lighting, 
alarms, nurses' call, equipment necessary — fer 
maintaining t e l e phone sorvio e , and r e o e ptaol e s in 
patient oorridors. — All other lighting and e quip 
mont required to bo connected to tho emergency 
system shall oithor be connected through tho 10 
second primary automatic transfer owitohing or 
shall bo subs e quently oonn e oted through other 
automatic or manual tran s fer s witching. — Rooopta 
clos connected to the emergency system shall bo 
distinctiv e ly marked for identification. 

— (9) Batt e ry pow e r e d corridor lights shall not r e plac e 

tho requ i rements for tho emergency circuit nor bo 
construed to substitute for tho generator — setr 
Suffici e nt fu e l shall be stored for th e operation of 
th e e m e rg e noy g e n e rator for a p e riod not leoo than 
72 hours, on a 24 hour per day operational basis. 
Tho systems shall bo test run for a period of not 
l e oo than — 15 minut e o on a w ee kly sch e dul e . 
R e cords of running tim e shall be maintained and 
kept available for reference. 

(10) To onsuro proper evaluation of dooign of omor 

g e noy pow e r syst e ms, th e own e r or op e rator shall 
submit with final working drawing s and s p e oifioa 
tions a letter describing tho policy for admissions 
and dischargee to bo used when tho facility begins 
op e ration. — If subs e qu e nt y e arly insp e ctions for 
lic e nsur e indicate th e admiooion polioi e o have boon 
changed, tho facility will bo required to take 
immediate stops to moot appropriate code require 
m e nto for continued licensure. 

Statutory Authority G.S. 13 IE- 104. 

.1806 GENERAL ELECTRICAL 

(a) All main water oupply shut off valves in th e sprinkl e r 
3ystom must bo electronically supervised so that if any valve 
is clo s ed an alarm will sound at a continuously manned - 
c e ntral station. 

(b) No two adjac e nt e m e rg e noy lighting fixtures shall bo 
on tho same circuit. 

(c) — Receptacles in bathrooms must have ground fault 
prot e ction. 



— (d) — Each patient bod location must bo provided with a 
minimum of four singl e or two duplex reo e ptaol e s. 

( e ) Eaoh pati e nt b e d location must b e ouppli e d by at least 
two branch oircuito. 

(f) Tho fire alarm system must be installed to transmit an 
alarm automatically to th e fir e D e partment that is legally 
committed to s e rv e th e area in whioh the facility io looat e d, 
by tho most direct and reliable method approved by local 
ordinances. 

(g) In pati e nt ar e as, fir e alarms shall b e gongo or ohimoo 
rather than horns or b e lls. 

(h) All receptacles in patient uso areas must bo grounded 
by an in s ulated oonduotor sized in accordance with Table 
950 95 of tho 1975 National Elootrio Cod e . 

Statutory Authority G.S. 131E-104. 

.1807 OTHER 

(a) In g e n e ral pati e nt ar e as, eaoh room shall bo sorvod by 
at least one calling station and each bod shall be provided 
with a call button. Two call buttons serving adjacent bods 
may b e s e rv e d by on e oalling station. — Calls shall r e gister 
with the floor staff and shall activat e a visibl e signal in th e 

corridor — at — the — patient' s — er — resident's — door. la 

multi corridor nursing unite, additional visible signals shall 
b e install e d at corridor inters e ct i ons. — In rooms containing 
two or mor e oalling stations, indicating lights shall b e 
provided at each station. — Nurses' oalling sy s tems w hich 
provide two way voice communication shall bo equipped 
with an indicating light at e aoh oalling station whioh lighto 
and r e mains lighted ao long as th e voio e oirouit io op e rating. 
A nurses' call emergency button shall bo provided for 
patients' and residents' uso at each patient and resident 
toil e t, bath, and show e r room. 

(b) At least one telephone ohall be availabl e in e aoh ar e a 
to which patients are admitted and additional telephone s or 
extensions as are necessary to onsuro availability in case of 



(o) G e n e ral outdoor lighting ohall b e provid e d ad e quate to 
illuminate walkways and drive. 

(d) A flow of hot water within safety ranges specified ao 
follows: 

Patient Areas 6 ' /4 gallons per hour per bod and at 

a temperature of 100 — 116 degree s F; and 

Di e tary S e rvic e s 4 gallons p e r hour p e r bod and at a 

t e mp e rature of 130 degrees — HO d e grooo F; and 

Laundry Areas 4 'A gallons per hour per bod and at 

a temperature of 130 dogroo s — 140 degrooo F. 

( e ) Plumbing syst e ms ohall moot th e r e quir e m e nts of th e 
North Carolina State Plumbing Code. 

(f) The Administrator shall assure that isolation facilities 
as approved by tho Departm e nt ohall b e available and uood 
for any pati e nt admitt e d or r e tain e d with a communicabl e 
disease. 

Statutory Authority G.S. 13 IE- 104. 



89 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



> 



SECTION .2000 - GENERAL INFORMATION 

.2001 DEFINITIONS 

The following definitions will app ly throughout this 
Subchapter: 

(1) "Abuse" means the willful infliction of injury, 
unreasonable confinement, intimidation or punish- 
ment with resulting physical harm, pain or mental 
anguish. 

(2) "Accident" means an unplanned or unwanted event 
resulting in die injury or wounding, no matter how 
slight, of a patient or other individual. 
"Accredited medical record technician" means a 



m 



£4} 



£51 



> 



£61 



m 



> 



£8} 
£91 

(10) 

an 



person trained in record maintenance and preser- 
vation, and accredited by the American Medical 
Record Association. 

"Adequate" means, when a pplied to various 
services, that the services are at least satisfactory 
in meeting a referred to need when measured 
against contemporary professional standards of 
practice. 

"Administrator" means a person licensed by the 
North Carolina State Board of Examiners for 
Nursing Home Administrators in accordance with 
G.S. 90-276. Article 20. and who has authority 
for and is responsible for the overall operation of 
a facility. 

"A ppropriate" means right, suitable or proper for 
the specified use or purpose, suitable or proper, 
when used as an adjective. When used as a 
transitive verb it means to set aside for some 
specified exclusive use, 

"Brain injury long term care" means an interdisci- 
plinary, intensive maintenance program for pa- 
tients who have incurred brain damage caused by 
external physical trauma and who have completed 
a primary course of rehabilitative treatment and 
have reached a point of no gain or progress for 
more than three consecutive months. Services are 
provided through a medically supervised interdis- 
ciplinary process and are directed toward main- 
taining the individual at the optimal level of 
physical, cognitive and behavioral functions. 
"Capacity" means the maximum number of patient 
or resident beds for which the facility is licensed 
to maintain at any given time. 
"Case manager" means the individual responsible 
for the coordination of services, for a given 
patient, between disciplines so that the patient may 
reach optimal rehabilitation through the judicious 
use of resources. 

"Combination facility" means a combination home 
as defined in G.S. 131E-101. 
"Comprehensive, inpatient rehabilitation program" 
means a program for the treatment of persons with 
functional limitations or chronic disabling condi- 



(12) 

(13) 
(14) 



(15) 
(16) 



(17) 

£al 



££l 
£il 
(18) 



tions who have the potential to achieve a signifi- 
cant improvement in activities of daily living. A 
comprehensive, rehabilitation program utilizes a 
coordinated and integrated, interdisciplinary 
a pproach, directed by a physician, to assess 
patient needs and to provide treatment and evalua- 
tion of physical, psychosocial and cognitive 
deficits. 

"Convalescent care" means care given for the 
purpose of assisting the patient or resident to 
regain health or strength. 

"Department" means the North Carolina Depart- 
ment of Human Resources. 

"Dietitian" means a person who meets the stan- 
dards and qualifications established by the Com- 
mission on Dietetic Registration of the American 
Dietetic Association included in "Standards of 
Practice" which is incorporated by reference. 



including subsequent amendments. Copies of the 
standards may be purchased for seven dollars and 
twenty five cents ($7.25) or "Code of Ethics for 
the Profession of Dietetics" for two dollars and 
fifteen cents ($2.15). from the American Dietetic 
Association. 216 W. Jackson Blvd.. Chicago. IL 
60606-6995. 

"Director of nursing" means a registered nurse 
who has authority and direct responsibility for all 
nursing services and nursing care. 
"Discharge" means a patient who physically 
relocates to another health care setting or is 
discharged home or relocated from a nursing bed 
to a domiciliary bed or from a domiciliary bed to 
a nursing bed. 
"Drug" means substances: 
recognized in the official United States Pharma- 
copoeia, official National Formulary, or any 
supplement to any of them: 
intended for use in the diagnosis, cure, mitiga- 
tion, treatment, or prevention of disease in man 
or other animals: 

intended to affect the structure or any function 
of the body of man or other animals, i.e.. 
substances other than food; and 
intended for use as a component of any article 
specified in Subitems (a), (b), or £cl of this 
Subparagraph. 
"Existing facility" means a facility currently 



(19) 



licensed or a proposed facility, proposed addition 
to a licensed facility or proposed remodeled 
licensed facility that will be built according to 
plans and specifications which have been a pproved 
by the Department through the design development 
drawings stage prior to the effective date of this 
Rule. 

"Exit conference" means the conference held at 
the end of a survey or investigation between the 
Department's representatives and the facility 



10:2 



NORTH CAROLINA REGISTER 



April 17, 1995 



90 



PROPOSED RULES 



administration representative. 

(20) "Facility" means a nursing facility or combination 
facility as defined in this Rule. 

(21) "Finding" (when used in conjunction with the 
Nurse Aide program) means a determination by 

the Department that an allegation of patient abuse (35) 

or neglect, or misappropriation of patient property 
has been substantiated. 

(22) "HIV Unit" means designated areas dedicated to 
patients or residents known to have Human Immu- 
nodeficiency Virus disease. 

(23) "Incident" means an unplanned or unwanted event 
which has not caused a wound or injury to any 
individual but which has the potential for such 
should the event be repeated. 

(24) "Inpatient rehabilitation facility or unit" means a (36) 
free-standing facility or a unit (unit pertains to 
contiguous dedicated beds and spaces) within an 
existing licensed health service facility a pproved in 
accordance with G.S. 131E, Article 9 to establish 
inpatient, rehabilitation beds and to provide a 
comprehensive, inpatient rehabilitation program. 

(25) "Interdisciplinary" means an integrated process 
involving a representative from appropriate disci- (37) 
plines of the health care team. 

(26) "Licensed" means holding a current and valid (38) 
license as required under the General Statutes of 

North Carolina. 

(27) "Licensed practical nurse" means a nurse who is 
licensed as a practical nurse under G.S. 90, (39) 
Article 9A. 

(28) "Licensee" means the person, firm, partnership, 
association, corporation or organization to whom 

a license has been issued. The licensee is the (40) 
legal entity which is responsible for the operation 
of the business. 

(29) "Medical consultations" means consultations which 

the rehabilitation physician, the attending physi- (41) 
cian or other authorized persons determine are 
necessary to meet the acute medical needs of the 
patient and do not include routine medical needs. (42) 

(30) "Medication" means drug as defined in Item (17) 

of this Rule. (43) 

(31) "Medication error rate" means a discrepancy 
between what was ordered and what is actually 
administered. It is the number of errors observed 
divided by the o pportunities for error times 100. (44) 

(32) "Misappropriation of property" means the deliber- 
ate misplacement, exploitation, or wrongful, (45) 
temporary or permanent use of a patient's belong- 
ings or money without the patient's consent- 
OS) "Neglect" means a failure to provide goods and (46) 

services necessary to avoid physical harm, mental 
anguish or mental illness. 
(34) "New facility" means a proposed facility, a pro- (47) 



(48) 



posed addition to an existing facility or a proposed 
remodeled portion of an existing facility that is 
constructed according to plans and specifications 



approved by the Department subsequent to the 
effective date of this Rule. If determined by the 
Department that more than half of an existing 
facility is remodeled, the entire existing facility 
shall be considered a new facility. 
"Nurse Aide" means a person who is listed on the 
N.C. Nurse Aide Registry and is in compliance 
with 42 CFR Part 483 which is incorporated by 
reference, including subsequent amendments. 
Copies of the Code of Federal Regulations may be 
purchased from the Superintendent of Documents, 
U.S. Government Printing Office. Washington. 
D.C. 20402 for thirty eight dollars ($38.00) and 
may be purchased with a credit card by a direct 
telephone call to the G.P.O. at (202) 783-3238. 
"Nurse aide trainee" means a person who has not 
completed an approved nurse aide training course 
and competency evaluation and is demonstrating 
knowledge, while performing tasks for which they 
have been found proficient by an instructor. 
These tasks shall be performed under the direct 
supervision of a registered nurse. The term does 
not apply to volunteers. 

"Nursing facility" means a nursing home as 
defined in G.S. 131E-104. 
" Nurse-in -charge " means the nurse to whom 
duties for a specified number of patients and staff 
for a specified period of time have been delegated, 
such as for Unit A on the 7^3 or 3-11 shift. 
"Occupational therapist" means a person licensed 
in the State of North Carolina as an occupational 
therapist in accordance with the provisions of G.S. 
90, Article 18D. 

"Occupational therapist assistant" means a person 
licensed in the State of North Carolina as an 
occupational therapist assistant in accordance with 
the provisions of G.S. 90. Article 18D. 
"On-duty personnel" means personnel who are 
responsive to patient needs and physically present 
in the facility performing assigned duties. 
"Patient" means any person admitted for nursing 
care. 

"Pharmaceutical care" means the provision of 
drug therapy and other pharmaceutical care ser- 
vices to achieve intended medication outcomes and 
minimize negative effects of drug therapy. 
"Pharmacist" means a person who is licensed to 
practice pharmacy in North Carolina. 
"Physician" means a person licensed under G.S. 
90. Article J. to practice medicine in North Caro- 
lina. 

" Proposal " means a Negative Action Proposal 
containing information that may ultimately be 
classified as violations. 

"Provisional License" means an amended license 
recognizing significantly less than full compliance 
with the licensure rules. 
"Psychologist" means a person licensed as a 



91 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



I 



I 



£49} 

(50) 
(51) 

(52) 

(53) 
(54) 

(55) 
(56) 



> 



(57) 

(58) 

(59) 
(60) 
(61) 



practicing psychologist in accordance with G.S. 
90. Article 18 A. 

"Physiatrist" means a licensed physician who has 
completed a physical medicine and rehabilitation 
residency training program a pproved by the 
Accrediting Council of Graduate Medical Educa- 
tion or the American Steopathic Association. 
"Physical therapist" means a person licensed in the 
State of North Carolina as a physical therapist in 
accordance with the provisions of G.S. 90. Article 
18B. 

"Physical therapist assistant" means a person 
licensed in the State of North Carolina as a physi- 
cal therapist assistant in accordance with the 
provisions of G.S. 90-270.24. Article 18B. 
"Recreational therapist" means a person certified 
by the State of North Carolina Therapeutic Recre- 
ational Certification Board. 
"Registered Nurse" means a nurse who is licensed 
as a registered nurse under G.S. 90. Article 9A. 
"Registered Records Administrator" means a 
person who is registered by the American Medical 
Record Association. 

"Rehabilitation nurse" means a registered nurse 
licensed in North Carolina, with training, either 
academic or on- the-iob. in physical rehabilitation 
nursing and at least one year experience in physi- 
cal rehabilitation nursing. 

"Rehabilitation aide" means an unlicensed assistant 
who works under the supervision of a registered 
nurse, licensed physical therapist or occupational 
therapist in accordance with the appropriate 
occupational licensure laws governing his or her 
supervisor and consistent with staffing require- 
ments as set forth in Rule .3027 of this Subchap- 
ter. Any rehabilitation aide, who works in a 
nursing department and is under the supervision of 
a registered nurse, shall be listed on the North 
Carolina Nurse Aide Registry and have received 
additional staff training as listed in Rule .3028 of 
this Subchapter. 

"Rehabilitation physician" means a physiatrist or 
a physician who is qualified, based on education, 
training and experience, regardless of specialty, to 
providing medical care to rehabilitation patients. 
"Remodeling" means alterations, renovations, 
rehabilitation work, repairs to structural systems. 
and replacement of building systems at a nursing 
facility. 

"Resident" means any person admitted for care to 
a domiciliary home part of a combination facility 
as defined in G.S. 131E-101. 
"Respite care" means services provided for per- 
sons admitted to a nursing facility on a temporary 
basis, not to exceed 30 days. 
"Significant medication error" means an error 
which causes the patient discomfort or jeopardizes 



the health and safety of the patient. Factors to 
consider when determining significance of error 
include the patient's condition, the drug category 
(need titration of blood levels, etc.) and frequency 
of the error. 

(62) "Single unit or unit dose package" means each 
dose of medication is individually packaged in a 
properly sealed and properly labeled container in 
accordance with the U.S. Pharmacopeia and 
professional standards. 

(63) "Sitter" means an employee or volunteer who 
provides companionship and social interaction to 
a particular patient, usually on a private duty 
basis. 

(64) "Social worker" means a person who meets the 
qualifications set forth in Rule .2902 of this 
Subchapter. 

(65) "Speech and language pathologist" means a person 
licensed ui the State of North Carolina as a speech 
and language pathologist in accordance with the 
provisions of G.S. 90. Article 22. 

(66) " Supervisor-in -charge " (domiciliary home) means 
any employee to whom supervisory duties for the 
domiciliary home portion of a combination home 
have been delegated by either the administrator or 
director of nursing. 

(67) "Surveyor" means an authorized representative of 
the Department who inspects nursing facilities and 
combination facilities to determine compliance 
with rules as set forth in G.S. 131E-1 17 and 
applicable state and federal laws, rules and regula- 
tions. 

(68) "Unit dose system" means a drug distribution 
system in which each dose of medication is con- 
tained in. and administered from, single unit or 
unit dose packages. 

(69) "Ventilator dependence" is defined as physiologi- 
cal dependency by a patient on the use of a venti- 
lator for more than eight hours a day. 

(70) "Violation" means a finding which directly relates 
to a patient's or resident's health, safety or wel- 
fare, or which creates a substantial risk that death 
or serious physical harm will occur. It is deter- 
mined to be an infraction of the regulations, 
standards and requirements set forth in G.S. 131E 
-117 and 131D-21 or applicable state and federal 
laws, rules and regulations. 

Statutory Authority G.S. 13 IE- 104. 

SECTION .2100 - LICENSURE 

.2101 APPLICATION REQUIREMENTS 

(a) An application for licensure for a new facility shall be 
submitted to the Medical Facilities Licensure Section of the 
Division of Facility Services at least 30 days prior to a 
license being issued or patients admitted. 



10:2 



NORTH CAROLINA REGISTER 



April 17, 1995 



92 



PROPOSED RULES 



£b} The 

01 
01 

01 

££> 
£51 
(61 
£21 
£81 

£21 



a pplication shall contain the following : 

legal identity of a pplicant (licensee) and mailing 

address; 

name or names under which the facility is 

presented to the public; 

location and mailing address of facility; 

ownership disclosure; 

accreditation data; 

bed compliment; 

magnitude and scope of services offered; 

name and current license number of the adminis- 



trator; and 

name and current license number of the director 

of nursing. 



Statutory Authority G.S. 131E-104. 

.2102 ISSUANCE OF LICENSE 

(a) Only one license shall be issued to each facility. The 
Department shall issue a license to the licensee of the 
facility following review of operational policies and proce- 
dures and verification of compliance with applicable laws 
and rules. 

£b) Licenses are not transferable. 

(c) The bed capacity and services provided in a facility 
shall be in compliance with G.S. 131E, Article 9 regarding 
Certificate of Need. 

(d) The license shall be posted in a prominent location. 
accessible to public view, within the licensed premises. 

Statutory Authority G.S. 131E-104. 

.2103 LENGTH OF LICENSURE 

Licenses shall remain in effect up. to .12 months, unless 
any of the following occurs: 
(1) Department imposes an administrative sanction 

which specifies license expiration; 

closure; 



m 

£4j 
£5} 
£6} 



change of ownership; 

change of site; 

change in bed compliment; or 

failure to comply with Rule .2104 of this Section. 



Statutory Authority G.S. 13 IE- 104. 

.2104 REQUIREMENTS FOR LICENSURE 
RENEWAL OR CHANGES 

(al The Department shall renew the facility's license at 
the end of each calendar year, if the following occur: 

(1) The licensee maintains and submits to the De- 
partment, at least 30 days prior to the licensure 
expiration date, statistical data for the State's 
medical facilities plan and review for certificate 
of need determination. The Department shall 
provide forms annually to the facility for this 
purpose. 

(2) The facility is in conformance with G.S. 
131E-102(c). " 



£21 



£21 
£41 



(b) The Medical Facilities Licensure Section of the 
Division of Facility Services shall be notified in writing and 
changes made in the licensure application at least 30 days 
prior to the occurrence of the following: 

(1) a change in the name or names under which the 
facility is presented to the public: 
a change in the legal identity (licensee) which 
has ownership responsibility and liability (such 
information shall be submitted by the proposed 
new owner): 

a change in the licensed bed capacity; or 
a chang e in the location of the facility. 
The Department shall issue a new license following notifica- 
tion and verification of data submitted. 

(c) The facility shall notify the Medical Facilities Licen- 
sure Section of the Division of Facility Services within one 
working day following the occurrence of: 

(1) change in administration; 

change in the director of nursing; 

change in facility mailing address or telephone 

number; 

changes in magnitude or scope of services; or 

emergencies or situations requiring relocation of 

patients to a temporary location away from the 

facility. 



£21 

£21 

£41 
£51 



Statutory Authority G.S. 131E-104. 

.2105 TEMPORARY CHANGE IN BED CAPACITY 

(a) A life care center, having an agreement to care for all 
residents regardless of level of care needs, may temporarily 
increase bed capacity by 10 percent or 10 beds, whichever 
is less, over the licensed bed capacity for a period up to 30 
days following notification of and a pproval by the Depart- 
ment. 

(b) A facility other than a life care center or combination 
home shall accept no more patients or residents than the 
total number for which it is licensed except in an emergency 
situation a pproved and confirmed in writing by the Medical 
Facilities Licensure Section of the Division of Facility 
Services. Emergency authorizations shall not exceed 30 
calendar days and shall not exceed the total licensed bed 
capacity for the facility. 

(c) The Department shall authorize, in writing, a tempo- 
rary increase in licensed beds in accordance with Paragraphs 
(a) and (b) of this Rule, if it is determined that: 

(1) the increase is not associated with a capital 
expenditure; and 

(2) the increase would not jeopardize the health, 
safety and welfare of the patients. 

Statutory Authority G.S. 13 IE- 104. 

.2106 DENIAL, AMENDMENT, OR REVOCATION 
OF LICENSE 

(a) The Department shall deny any licensure a pplication 
upon becoming aware that the a pplicant is not in compliance 
with G.S. 131E. Article 9 and the rules adopted under that 



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PROPOSED RULES 



law. 

(b) The Department may amend a license by reducing it 
from a full license to a provisional license whenever the 
Department finds that: 

(1) the licensee has substantially failed to comply 
with the provisions of G.S. 131E. Article 6 and 
the rules promulgated under that article; 

(2) there is a reasonable probability that the licensee 
can remedy the licensure deficiencies within a 
reasonable length of time; and 

(3) there is a reasonable probability that the licensee 
will be able thereafter to remain in compliance 
with the licensure rules for the foreseeable 
future. 

(c) The Department shall give the licensee written notice 
of the amendment to the license. This notice shall be given 
personally or by certified mail and shall set forth: 

(1) the length of the provisional license; 

(2) the factual allegations: 

(3) the statutes or rules alleged to be violated; and 

(4) notice of the facility's right to a contested case 
hearing on the amendment of the license. 

(d) The provisional license shall be effective immediately 
upon its receipt by the licensee and shall be posted in a 
prominent location within the facility, accessible to public 
view, in lieu of the full license. The provisional license 
shall remain in effect until: 

(1) the Department restores the licensee to full 

licensure status; or 
£2} the Department revokes the licensee's license. 

(e) If a licensee has a provisional license at the time the 
licensee submits the annual utilization data, the provisional 
license shall remain in effect unless the Department deter- 
mines that the licensee can be returned to full licensure 
status. 

(f) The Department may revoke a license whenever: 

(1) The Department finds that: 

(A) the licensee has substantially failed to comply 
with the provisions of G.S. 131E. Article 6 
and the rules promulgated under that article; 
and 

(B) it is not reasonably probable that the licensee 
can remedy the licensure deficiencies within a 
reasonable length of time: or 

(2) The Department finds that: 

(A) the licensee has substantially failed to comply 
with the provisions of G.S. 131E. Article 6; 
and 

(B) although the licensee may be able to remedy 
the deficiencies within a reasonable time, it is 
not reasonably probable that the licensee will 
be able to remain in compliance with licensure 
rules for the foreseeable future: or 

(3) The Department finds that there has been any 
failure to comply with the provisions of G.S. 
131E. Article 6 and the rules promulgated under 
that article that endanger the health, safety or 



welfare of the patients in the facility. 

(g~) The issuance of a provisional license is not a proce- 
dural prerequisite to the revocation of a license pursuant to 
Paragraph (f) of this Rule. 

(h) The Department can, in accordance with G.S. 
131E-232. petition to have a temporary manager a ppointed 
to operate a facility. 

Statutory Authority G.S. 131E-104. 

.2107 SUSPENSION OF ADMISSIONS 

(a) The Department may suspend the admission of any 
new patient to any facility when warranted under the 
provisions of G.S. 131E-109(c). 

(b) The Department shall notify the facility personally or 
by certified mail of the decision to suspend admissions- 
Such notice shall include: 

(1) factual allegations: 

(2) citation of statutes and rules alleged to be vio- 
lated: and 

(3) notice of the facility's right to a contested case 
hearing on the suspension. 

(c) The suspension shall be effective when the notice is 
served or on the date specified in the notice of suspension, 
whichever is later. The suspension shall remain effective 
until the facility demonstrates to the Department that 
conditions are no longer detrimental to the health and safety 
of the patients. 

(d) The facility shall not admit new patients during the 
effective period of the suspension. 

(e) Patients requiring hospitalization during the period of 
suspension of admissions shall be readmitted after hospital- 
ization or on return from temporary care to the facility 
based on the availability of a bed and the ability of the 
facility to provide necessary care. Upon return from the 
hospital, the requirements of G.S. 131E-130 shall a pply. 

Statutory Authority G.S. 131E-104. 

.2108 PROCEDURE FOR APPEAL 

(a) The facility may appeal any decision of the Depart- 
ment to deny, revoke or alter a license or any decision to 
suspend admissions by making such an a ppeal in accordance 
with G.S. 150B and 10 NCAC IB .0200. 

(b) A decision to issue a provisional license is stayed 
during the pendency of an administrative a ppeal and the 
licensee may continue to display full license during the 
a ppeal . 

Statutory Authority G.S. 13 IE- 104. 

.2109 INSPECTIONS 

(a) The facility shall allow inspection by an authorized 
representative of the Department at any time. 

(b) At the time of inspection, any authorized representa- 
tive of the Department shall make his or her presence 
known to the administrator or other person in charge who 



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PROPOSED RULES 



shall cooperate with the representative and facilitate the 
inspection. 

(c") Inspections of medical records will be carried out in 
accordance with G.S. 131E-105. 

£d) The administrator shall provide and make available to 
representatives of the Department financial and statistical 
records required to verify compliance with all rules con- 
tained in this Subchapter. 

(e) The Department shall mail a written report to the 
facility within 10 working days from the date of the licen- 
sure survey or complaint investigation exit conference. The 
report shall include statements of any deficiencies or 
violations cited during the survey or investigation. 

£f) The administrator shall prepare a written plan of 
correction and mail it to the Department within 10 working 
days following receipt of any statement of deficiencies or 
violations. The Department shall review and accept or 
reject the plan of correction, with written notice given to the 
administrator within 10 working days following receipt of 
the plan. 

Statutory Authority G.S. 131E-104. 

.2110 PUBLIC ACCESS TO DEPARTMENT 
LICENSURE RECORDS 

(a) All Department files pertaining to the licensure of any 
facility under this Subchapter shall be open for inspection by 
any member of the public during normal business hours. 
The Department shall have an opportunity to ensure that 
none of the information identified in Paragraph (b) of this 
Rule will be disclosed during the inspection. Except for 
information identified in Paragraph (b) of this Rule, any 
member of the public may obtain copies of any information 
contained in the Department licensure files in accordance 
with Division of Facility Services Directive 30. Publication 
Guidelines, which is incorporated by reference, including 
subsequent amendments. A copy of the directive may be 
obtained, without charge, from the Medical Facilities 
Licensure Section. Division of Facility Services. P.O. Box 
29530. Raleigh. NC 27626-0530. 

(b) Unless disclosure is ordered by a court of competent 
jurisdiction, the following classes of information shall not be 
disclosed to members of the public: 

(1) information about the diagnosis, prognosis, 
treatment, or any other confidential medical 
information under G.S. 8-53. regarding a named 
person, unless that person consents in writing to 
the disclosure; 

(2) the name of any person who provided informa- 
tion concerning a facility licensed under this 
Subchapter, or registered a complaint about the 
treatment of a patient unless that person consents 
to the disclosure; 

(3) information identifying any person as a recipient 
of public assistance or social services, unless 
that person consents to the disclosure; and 

£4} any confidential communication between the 
attorney for the Department and the Department. 



(c) When documents in the file contain only confidential 
information of the types identified in Paragraph (b) of this 
Rule, then they shall be removed from the file before 
inspection. If a document contains both information of 
those types identified in Paragraph (b) of this Rule and 
non-confidential information, then the Department will 
provide for inspection a copy of the document from which 
the confidential information is deleted, in lieu of the original 
document. 

Statutory Authority G.S. 8-53; 108A-80; 131E-104; 
131E-124(c); 132-1.1. 

SECTION .2200 - GENERAL STANDARDS OF 
ADMINISTRATION 

.2201 ADMINISTRATOR 

(a) The facility shall be under the direct management 
control of an administrator. The administrator shall not 
serve simultaneously as the director of nursing. 

(b) If an administrator is not the sole owner of a facility, 
his or her authority and responsibility shall be clearly 
defined in a written agreement or in the facility's governing 
bylaws. 

(c) The administrator shall be responsible for the opera- 
tion of a facility on a full-time basis. 

(d) The administrator shall ensure patient services are 
provided in accordance with all a pplicable local, state and 
federal regulations and codes, and with acceptable standards 
of practice that apply to professionals providing such 
services in the facility. 

(e) The administrator shall be responsible for developing 
and implementing policies for the management and operation 
of the facility. 

(f) In the temporary absence of the administrator, a 
person shall be on-site who is designated to be in charge of 
the overall facility operation. 

Statutory Authority G.S. 90-284; 131E-104. 

.2202 ADMISSIONS 

(a) No patient shall be admitted except by a physician or 
other persons legally authorized to admit patients. Admis- 
sion shall be in accordance with facility policies and 
procedures. 

(b) The administrator shall ensure patients receive 
communicable disease screening, including tuberculosis, in 
accordance with Rule .2209 of this Section. 

(c) The facility shall acquire, prior to or at the time of 
admission, orders from the attending physician for the 
immediate care of the patient. 

(d) Within 48 hours of admission, the facility shall 
acquire medical information which shall include current 
medical findings, diagnosis, and a summary of the hospital 
stay if the patient is being transferred from a hospital. 

£e} If a patient is admitted from somewhere other than a 
hospital, the facility shall acquire a copy of the patient's 
most recent medical history and physical, which shall have 



♦ 



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NORTH CAROLINA REGISTER 



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10:2 



PROPOSED RULES 



been updated within the preceding six months. 

(f) Only persons who are 18 years of age or older shall 
be admitted to the domiciliary portion of a combination 
facility. 

Statutory Authority G.S. 131E-104. 

.2203 PATIENTS NOT TO BE ADMITTED 

(a) Patients who require health, habilitative or rehabilita- 
tive care or training beyond those for which the facility is 
licensed and is capable of providing shall not be admitted. 

(b) No person requiring continuous nursing care shall be 
admitted to a domiciliary bed in a combination facility. 
Should an existing resident of a domiciliary bed require 
continuous nursing care, the administrator shall provide the 
next available nursing facility bed (that is not needed to 
comply with G.S. 131E-130) to the resident to ensure 
continuity of care and to prevent discharge from the facility. 

Statutory Authority G.S. 131E-104. 

.2204 RESPITE CARE 

(a) Respite care is not required as a condition of licen- 
sure. Facilities providing respite care, however, shall meet 
the requirements of this Subchapter with the following 
exceptions: Rules .2205. .2301. and .25010)) and (c) of this 
Subchapter. 

(b) Facilities providing respite care shall meet the 
following additional requirements: 

(1) A patient's descriptive record of stay shall 
include the preadmission or admission assess- 
ment, interdisciplinary notes as warranted by 
episodic events, medication administration 
records and a summary of the stay u pon dis- 
charge. 

(2) The facility shall complete a preadmission or 
admission assessment which allows for the 
development of a short-term plan of care and is 
based on the patient's customary routine. The 
assessment shall address needs, including but not 
limited to identifying information, customary 
routines, hearing, vision, cognitive ability, 
functional limitations, continence, special proce- 
dures and treatments, skin conditions, behavior 
and mood, oral and nutritional status and medi- 
cation regimen. The plan shall be developed to 
meet the respite care patient's needs. 

(3) The attending physician of the respite care 
patient will be notified of any acute changes or 
acute episode which warrant medical involve- 
ment. Medical orders and progress notes shall 
be written following the physician's visits. 

Statutory Authority G.S. 13 IE- 104. 

.2205 DISCHARGE OF PATIENTS 

(a) The facility shall ensure a medical order for discharge 



is obtained for all patients except when a patient leaves 
against medical advice or is discharged for non-payment. 

(b) The facility shall ensure discharge planning is accom- 
plished according to each patient's needs when a discharge 
is anticipated. 

(c) The facility shall ensure the patient or the legal 
representative is informed and included in the discharge 
planning process. 

Statutory Authority G.S. 131E-104. 

.2206 MEDICAL DIRECTOR 

(a) The facility shall designate a physician to serve as 
medical director. 

(b) The medical director shall be responsible for imple- 
mentation of patient care policies and coordination of 
medical care in the facility. 

Statutory Authority G.S. 13 IE- 104. 

.2207 PATENT RIGHTS 

(a) The facility shall enforce the Nursing Facility Pa- 
tient's Bill of Rights as described in G.S. 1 31E-115 through 
G.S. 131E-127. 

(b) In matters of patient abuse, neglect or misappropria- 
tion the definitions shall have the meaning defined in Rule 
.2001 of this Subchapter. 

Statutory Authority G.S. 13 IE- 104; 131E-131. 

.2208 SAFETY 

(a) The facility shall have detailed written plans and 
procedures to meet potential emergencies and disasters, 
including but not limited to fire, severe weather and missing 
patients or residents. 

(b) The plans and procedures shall be made available 
upon request to local or regional emergency management 
offices. 

(c) The facility shall provide training for all employees in 
emergency procedures upon employment and annually. 

(d) The facility shall conduct unannounced drills using the 
emergency procedures. 

(e) The facility shall ensure that: 

(1) the patients' environment remains as free of 
accident hazards as possible; and 

(2) each patient receives adequate supervision and 
assistance to prevent accidents. 

Statutory Authority G.S. 13 IE- 104. 

.2209 INFECTION CONTROL 

(a) The facility shall establish and maintain an infection 
control program for the purpose of providing a safe, clean 
and comfortable environment and preventing the transmis- 
sion of diseases and infection. 

(b) Under the infection control program, the facility shall 
decide what procedures, such as isolation techniques, are 



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96 



PROPOSED RULES 



needed for individual patients, investigate all episodes of 
infection and attempt to control and prevent infections in the 
facility. 

(c) The facility shall maintain records of all infections and 
of the corrective actions taken. 

(d) The facility shall ensure communicable disease 
screening, including tuberculosis, prior to admission of all 
patients and within seven days upon the hiring of all staff; 
and tuberculosis screening annually thereafter for patients 
and staff as required by 15A NCAC 19A .0101 "Communi- 
cable Disease Control " which is incorporated by reference, 
including subsequent amendments. Copies of these Rules 
may be obtained at no charge by contacting the N.C. 
Department of Environment. Health, and Natural Resources. 
Tuberculosis Control branch. P.O. Box 27687. Raleigh. 
North Carolina 27611-7687. Identification of a communica- 
ble disease does not, in aH cases, in and of itself, preclude 
admission to the facility. 

(e) All cases of reportable disease as defined by 15A 
NCAC 19A "Communicable Disease Control" and epidemic 
outbreaks, and poisonings shall be reported immediately to 
the local health department. 

(f) The facility shall isolate any patient deemed appropri- 
ate by the infection control program. 

(g) The facility shall prohibit any employee with a 
communicable disease or infected skin lesion from direct 
contact with patients or their food, if direct contact is the 
mode of transmission of the disease. 

(h) The facility shall require all staff to use good hand 
washing technique as indicated by accepted professional 
practice. 

(i) All linen shall be handled, store, processed and 
transported so as to prevent the spread of infection. 

Statutory Authority G.S. 13 IE- 104. 

.2210 REPORTING AND INVESTIGATING 
ABUSE, NEGLECT OR 
MISAPPROPRIATION 

(a) The facility shall take reasonable measures to prevent 
patient abuse, patient neglect, or misappropriation of patient 
property, including but not limited to orientation and 
instruction of facility staff on patients' rights, and the 
screening of and requesting of references for all prospective 
employees. 

(b) The administrator shall ensure that the Complaint 
Investigation Branch of the Division of Facility Services is 
notified within 24 hours or as soon as practicable of all 
allegations which a ppear to a reasonable person to be related 
to patient abuse, neglect or misappropriation of patient 
property. 

(c) The facility shall thoroughly investigate allegations of 
patient abuse, patient neglect, or misappropriation of patient 
property in accordance with 42 CFR subsection 483.13 
which is incorporated by reference, including subsequent 
amendments, and shall document all relevant information 
pertaining to such investigation and shall take whatever steps 
are necessary to prevent further incidents of abuse, neglect 



or misappropriation of patient property while the investiga- 
tion is in progress. Copies of the Code of Federal Regula- 
tions may be purchased from the Superintendent of Docu- 
ments. U.S. Government Printing Office. Washington. D.C. 
20402 for thirty eight dollars ($38.00*) and may be pur- 
chased with a credit card by a direct telephone call to the 
G.P.O. at (202) 783-3238. 

(d) The administrator shall ensure that the report of 
investigation is printed or typed and postmarked to the 
Complaint Investigation Branch of the Division of Facility 
Services within five working days of the allegation. The 
report shall include the date and time of the alleged incident 
of abuse, neglect or misappropriation of property; the 
patient's full name and room number; details of the allega- 
tion and any injury; names of the accused and any wit- 
nesses; names of the facility staff who investigated the 
allegation; results of the investigation: and any corrective 
action that may have been taken by the facility. 

Statutory Authority G.S. 131E-104; 131E-111; 131E-131. 

.2211 PERSONNEL STANDARDS 

(a) The facility shall employ the types and numbers of 
professional and non-professional staff to ensure the health, 
safety and proper care of patients. 

(1) Each employee shall be assigned duties consis- 
tent with his or her job description and with his 
or her level of education and training. 

(2) Professional staff shall be licensed, certified or 
registered in accordance with a pplicable state 
laws. 

(3) The facility shall provide orientation regarding 
facility policies and procedures for all staff upon 
employment. 

(4) The facility shall train all staff periodically in 
accordance with their j ob duties. 

(b) The facility shall maintain an individual personnel 
record for each employee, including verification of creden- 
tials. 

(c) The facility shall have a written agreement with any 
nursing personnel agency providing staff to the facility and 
shall ensure orientation of agency staff who work in the 
facility. 

Statutory Authority G.S.131E-104. 

.2212 QUALITY ASSURANCE COMMITTEE 

(a) The administrator shall ensure that a quality assess- 
ment and assurance committee is actively maintained and 
consists of the director of nursing, a physician designated by 
the facility, a pharmacist and at least three other staff 
members. 

(b) The committee shall meet at least quarterly. 

(c) The committee shall develop and implement appropri- 
ate plans of action which will correct identified quality care 
problems. 

Statutory Authority G.S. 13 IE- 104. 



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PROPOSED RULES 



SECTION .2300 - PATIENT AND RESIDENT 
CARE AND SERVICES 

.2301 PATIENT ASSESSMENT AND CARE 
PLANNING 

(a) At the time each patient is admitted, the facility shall 
ensure physician orders are available for the patient's 
immediate care and that, within 24 hours, a nursing assess- 
ment of immediate needs is completed by a registered nurse 
and measures implemented as a ppropriate. 

(b) The facility shall perform, within 14 days of admis- 
sion and at least annually, a comprehensive, accurate, 
documented assessment of each patient's capability to 
perform daily life functions. This comprehensive assess- 
ment shall be coordinated by a registered nurse and shall 
include at least the following: 

(1) current medical diagnoses; 

(2) medical status measurements, including current 
cognitive status, stability of current conditions 
and diseases, vital signs, and abnormal lab 
values and diagnostic tests that are a part of the 
medical history; 

(3) the patient's ability to perform activities of daily 
living, including the need for staff assistance and 
assistive devices, and the patient's ability to 
make decisions; 

(4) presence of neurological or muscular deficits; 

(5) nutritional status measurements and require- 
ments, including but not limited to height, 
weight, lab work, eating habits and preferences, 
and any dietary restrictions; 

(6) special care needs, including but not limited to 
pressure sores, enteral feedings, specialized 
rehabilitation services or respiratory care; 

(7) indicators of special needs related to patient 
behavior or mood, interpersonal relationships 
and other psychosocial needs; 

(8) facility's expectation of discharging the patient 
within the three months following admission; 

(9) condition of teeth and gums, and need and use 
of dentures or other dental a ppliances; 

(10) patient's ability and desire to take part in activi- 
ties, including an assessment of the patient's 
normal routine and lifetime preferences; 

(11) patient's ability to improve in functional abilities 
through restorative care; and 

(12) presence of visual, hearing or other sensory 
deficits. 

(c) The facility shall develop a comprehensive care plan 
for each patient and shall include measurable objectives and 
timetables to meet needs identified in the comprehensive 
assessment. The facility shall ensure the comprehensive 
care plan is developed within seven days of completion of 
the comprehensive assessment by an interdisciplinary team 
that includes a nurse with responsibility for the patient and 
representatives of other appropriate disciplines as dictated by 



the needs of the patient. To the extent practicable, prepara- 
tion of the comprehensive care plan should include the 
participation of the patient and the patient's family or legal 
representative. The physician may participate by alternative 
methods, including, but not limited to. telephone or 
face-to-face discussion, or written notice. 

(d) The facility shall review comprehensive assessments 
and care plans no less frequently than once every 90 days 
and make necessary revisions to ensure accuracy. 

Statutory Authority G.S. 13 IE- 104. 

.2302 NURSING SERVICES 

(a) The facility shall designate a registered nurse to serve 
as the director of nursing on a full-time basis. 

(b) The director of nursing shall be responsible for the 
administering of nursing services. 

(c) The director of nursing may serve also as charge 
nurse, only if the average daily occupancy is less than 60. 

(d) The director of nursing shall not serve as administra- 
tor, assistant administrator or acting administrator during an 
employment vacancy in the administrator position. 

Statutory Authority G.S. 131E-104. 

.2303 NURSE STAFFING REQUD1EMENTS 

(a) The facility shall provide licensed nursing personnel 
consistent with applicable occupational regulations and 
sufficient to accomplish the following: 

(1) patient needs assessment; 

(2) patient care planning; and 

(3) supervisory functions in accordance with the 
levels of patient care advertised or offered by 
the facility. 

£b) The facility shall provide other nursing personnel 
sufficient to ensure that activities of daily living, personal 
grooming, restorative nursing actions and other health care 
needs, as identified in each patient's plan of care, are met. 

(c) A multi-storied facility shall have at least one di- 
rect-care staff member on duty on each patient care floor at 
all times. 

(d) Except for designated units with higher staffing 
requirements noted elsewhere in this Subchapter, daily direct 
patient care nursing staff, licensed and unlicensed, shall 
equal or exceed 2.1 nursing hours per patient per day. 
(This is sometimes referred to as nursing hours per patient 
day or NHPPD or NH/PD.) 

(1) Inclusive in these nursing hours is the require- 
ment that at least one licensed nurse is on duty 
for direct patient care at all times. 

(2) Nursing care shall include the services of a 
registered nurse for at least eight consecutive 
hours a day, seven days a week. This coverage 
can be spread over more than one shift if such a 
need exists. The director of nursing may be 
counted as meeting the requirements for both the 
director of nursing and patient staffing for 



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PROPOSED RULES 



facilities with a total census of 60 nursing beds 
or less. 
(31 Nursing support personnel, including ward 
clerks, secretaries, nurse educators and persons 
in primarily administrative management positions 
and not actively involved in direct patient care, 
shall not be counted toward compliance with 
minimum daily requirements for direct care 
staffing, 
(e) An exception to meeting the minimum staffing 
requirements shall be reported to the Department at the end 
of each month. Staffing waivers granted by the federal 
government for Medicare and Medicaid certified beds shall 
be accepted for licensure purposes. 

Statutory Authority G.S. 131E-104. 

.2304 NURSE AIDES 

(a) The facility shall employ or contract individuals as 
nurse aides in compliance with 42 CFR Part 483 which is 
incorporated by reference, including subsequent amend- 
ments. Copies of the Code of Federal Regulations may be 
purchased from the Superintendent of Documents, U.S. 
Government Printing Office. Washington. D.C. 20402 for 
thirty eight dollars ($38.00) and may be purchased with a 
credit card by a direct telephone call to the G.P.O. at (202) 
783-3238. 

(b) The facility shall provide to the Department, upon 
request, verification of in-service training and of past or 
present employment of any nurse aide employed by the 
facility. 

Authority G.S. 131E-104; 131E-1U; 143B-165; 42 U.S.C. 
1395; 42 U.S.C. 1396. 

.2305 QUALITY OF CARE 

(a) The facility shall provide necessary care and services 
in accordance with physician's orders, the patient's compre- 
hensive assessment and on-going plan of care. 

(b) Acute changes in the patient's physical, mental or 
psychosocial status shall be evaluated and reported to the 
physician. 

(c) The facility shall not utilize any chemical or physical 
restraints for the purpose of discipline or convenience, and 
that are not required to treat the patient's medical condition. 
An evaluation shall be done to ensure that the least restric- 
tive means of restraint have been initiated on patients 
requiring restraints. 

(d) The facility shall ensure that all patients who are 
unable to perform activities of daily living receive the 
necessary assistance to maintain good grooming, and oral 
and personal hygiene. The facility shall ensure a ppropriate 
measures are taken to restore the patient's ability to bathe, 
dress, groom, transfer and ambulate, toilet and eat. 

(e) The facility shall ensure measures are taken to prevent 
the formation of pressure sores and to promote healing of 
existing pressure sores. The facility shall ensure that 
patients with limited mobility receive a ppropriate care to 



promote comfort and maintain skin integrity. 

£f) The facility shall ensure that in -dwelling catheters are 
not used unless the patient's clinical condition necessitates 
their use. The facility shall ensure incontinent patients 
receive appropriate treatment to prevent infections and to 
regain continence to the degree possible. 

(g) The facility shall ensure that patients with limited 
range of motion, or who are at risk for loss of range of 
motion, receive treatment services to prevent development 
of contractures or deformities, and to obtain and maintain 
their optimal level of functioning. 

(h) The facility shall ensure that patients who are unable 
to feed themselves receive the appropriate assistance, 
retraining and assistive devices when needed. 

£i) The facility shall ensure that enteral feeding tubes are 
used only when the patient's condition indicates the use of 
an enteral feeding tube is unavoidable. 

(j) The facility shall ensure that patients fed by enteral 
feeding tubes receive the proper treatment to avoid aspira- 
tion pneumonia, metabolic and gastrointestinal problems, 
and to restore the patient to the highest practicable level of 
normal feeding function. The facility shall ensure a ppropri- 
ate care and services are provided to address needs related 
to hydration and nutrition. 

(k) The facility shall ensure that patients requiring special 
respiratory care receive a ppropriate services. 

£1) The facility shall ensure that patients are assisted to 
utilize personal visual lenses, hearing aids and dentures. 

Statutory Authority G.S. 131E-104. 

.2306 MEDICATION ADMINISTRATION 

(a) The facility shall ensure that medications are adminis- 
tered in accordance with standards of professional practice 
and a pplicable occupational licensure regulations. 

(b) The facility shall ensure that each patient's drug 
regimen is free from drugs used in excessive dose or 
duplicative therapy, for excessive duration or without 
adequate indications for the prescription of the drug. Drugs 
shall not be used without adequate monitoring or in the 
presence of adverse conditions that indicate the drugs' usage 
should be modified or discontinued. 

(c) Antipsychotic therapy shall not be initiated on any 
patient unless necessary to treat a clinically diagnosed and 
clinically documented condition. When antipsychotic 
therapy is prescribed, unless clinically contraindicated. 
gradual dose reductions and behavioral interventions shall be 
employed in an effort to discontinue these drugs. 

(d) The facility shall ensure that procedures aimed at 
minimizing medication error rates include, but are not 
limited to. the following: 

(1) All medications or drugs and treatments shall be 
administered and discontinued in accordance 
with signed physician orders which are recorded 
in the patient's medical record. Such orders 
shall be complete and include drug name, 
strength, quantity to be administered, route of 
administration, frequency and, if ordered on an 



♦ 



99 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



m 



££} 

mi 



£21 



£5} 



£6} 

£21 

£8J 



as-needed basis, a clearly stated indication for 
use. 

The requirements for self-administration of 
medication shall include, but not be limited to. 
the following: 
determination by the interdisciplinary team that 
this practice is safe; 

administration ordered by the physician; 
specific instructions for administration printed 
on the medication label; and 
administration of medication monitored by the 
licensed nursing staff and consultant pharma- 
cist. 
The administration of one patient's medications 
to another patient is prohibited except in the case 
of an emergency. In the event of such emer- 
gency, steps shall be taken to ensure that the 
borrowed medications are replaced promptly and 
so documented. 

Omission of medications and the reason for 
omission shall be indicated in the patient's 
medical record. 

Medication administration records shall provide 
time of administration, identification of the drug 
and strength of drug, quantity of drug adminis- 
tered, route of administration, frequency, name 
of administering employee and title of employee- 
Medication administration records shall indicate 
documentation of injection sites and topical 
medication sites requiring rotation, including, 
but not limited to. transdermal medication. 
The pharmacy shall receive an exact copy of 
each physician's order for medications and 
treatments- 
Automatic stop orders for medications and 
treatments shall be established and implemented. 
The facility shall maintain an accountability of 
controlled substances as defined by the North 
Carolina Controlled Substances Act. G.S. 90. 
Article 5. 



Statutory Authority G.S. 13 IE- 104. 

.2307 DENTAL CARE AND SERVICES 

(a) The facility shall ensure that routine and emergency 
dental services are available for all patients. 

(b) The facility shall, if necessary, assist the patient in 
making a ppointments and obtaining transportation to the 
dentist's office- 



supervisor in charge of the domiciliary beds. 

(b) If domiciliary beds are located in a separate building 
or a separate level of the same building, there shall be a 
person on duty in the domiciliary portion of the facility at 
all times. 

(c) The facility shall comply with all rules in Subchapter 
10 NCAC 42D. Licensing of Homes for the Aged and 
Infirm, which is incorporated by reference, including all 
subsequent amendments. Copies of these Rules can be 
obtained free of charge from the Division of Facility 
Services. Domiciliary and Group Care Section. P.O. Box 
29530. Raleigh. NC 27626-0530. 

Statutory Authority G.S. 131E-104. 

SECTION .2400 - MEDICAL RECORDS 

.2401 MAINTENANCE OF MEDICAL RECORDS 

(a) The facility shall establish a medical records service. 
It shall be directed, staffed and equipp ed to ensure: 

(1) records are processed, indexed and filed accu- 
rately; 

(2) records are stored in such a manner as to pro- 
vide protection from loss, damage or unautho- 
rized use; 

(3) records contain sufficient information to identify 
the patient p lus a record of aU assessments; plan 
of care: pre-admission screening, if a pplicable; 
records of implementation of plan of care; 
progress notes; and record of discharge, includ- 
ing a discharge summary signed by the physi- 
cian: and 

(4) records are readily accessible by authorized 
personnel. 

(b) The facility shall ensure that a master patient index is 
maintained, listing patients alphabetically by name, dates of 
admission, dates of discharge and case number. 

(c) The administrator shall designate an employee who 
works full-time to be the medical records manager. The 
manager shall advise, administer, supervise and perform 
work involved in the development, analysis, maintenance 
and use of medical records and reports. If that employee is 
not qualified by training or experience in medical record 
science, he or she shall receive consultation from a regis- 
tered records administrator or an accredited medical record 
technician to ensure compliance with rules contained in this 
Subchapter. The facility shall provide orientation, 
on-the-job training and in-service programs for all medical 
records personnel. 



Statutory Authority G.S. 131E-104. 

.2308 DOMICILIARY HOME PERSONNEL 
REQLTREMENTS 

(a) The administrator shall designate a person to be in 
charge of the domiciliary home residents at all times. The 
nurse in charge of the nursing facility may also serve as 



Statutory Authority G. S. 131E-104. 

.2402 PRESERVATION OF MEDICAL RECORDS 

(a) The manager of medical records shall ensure that 
medical records, whether original, computer media or 
microfilm, be kept on file for a minimum of jj. years 
following the discharge of an adult patient. 



10:2 



NORTH CAROLINA REGISTER 



April 17, 1995 



100 



PROPOSED RULES 



(b) The manager of medical records shall ensure that if 
the patient is a minor, records shall be kept on file until his 
or her 19th birthday and, then, for 11 years. 

£c] If a facility discontinues operation, the licensee shall 
make known to the Division of Facility Services where its 
records are stored. Records are to be stored in a business 
offering retrieval services for at least 11 years after the 
closure date. 

(d) Prior to destruction, public notice shall be made to 
permit former patients or their representatives to claim their 
own records. Public notice shall be in at least two forms. 

£e} The manager of medical records may authorize the 
microfilming of medical records. Microfilming may be 
done on or off the premises. If done off the premises, the 
facility shall take precautions to ensure the confidentiality 
and safekeeping of the records. The original of the micro- 
filmed medical records shall not be destroyed until the 
manager of medical records has had an opportunity to 
review the processed film for content. 

(f) Nothing in this Subchapter shall be construed to 
prohibit the use of automation of medical records, provided 
that all of the provisions in this Rule are met and the 
medical record is readily available for use in patient care. 

£g) All medical records are confidential. Only authorized 
personnel shall have access to the records. Signed authori- 
zation forms concerning approval or disapproval of release 
of medical information outside the facility shall be a part of 
each patient's medical record. Representatives of the 
Department shall be notified at the time of inspection of the 
name and record number of any patient who has denied 
medical record access to the Department. 

(h) Medical records are the property of the facility, and 
thev shall not be removed from the facility except through 
a court order. Copies shall be made available for authorized 
purposes such as insurance claims and physician review. 

Statutory Authority G.S. 13 IE- 104. 

SECTION .2500 - PHYSICIAN'S SERVICES 

.2501 AVAILABILITY OF PHYSICIAN'S 
SERVICES 

(a) The facility shall ensure each patient's care is super- 
vised by a physician and that provisions are made for 
emergency physicians when attending physicians are 
unavailable. The names and telephone numbers of the 
designated physicians shall be posted at each nurse's station. 

(b) Patients shall be seen by a physician at least once 
every 30 days for the first 90 days and at least every 60 
days thereafter. Following the first 90 days, the physician 
may delegate this responsibility to a physician assistant or 
nurse practitioner every other visit. A physician's visit is 
considered timely if the visit occurs not later than 10 days 
after the visit was required. 

(c) Physicians shall review the patient's medical plan of 
care, write or dictate and sign progress notes; and sign and 
date all current orders at each visit. 

(d) A physician's oral orders, including telephone orders. 



shall be given only to a nurse or other licensed professional 
who by law is allowed to accept physician's orders, except 
orders for therapeutic diets which shall be given either to a 
qualified dietitian or licensed nurse. The record of each 
telephone order shall include the name of physician giving 
the order, date and time of order, content of order and name 
of person receiving the order. The physician who gives oral 
orders shall sign the orders within five days. 

Statutory Authority G.S. 131E-104. 

.2502 PRIVATE PHYSICIAN 

(a) Each patient or legal representative shall be allowed 
to select his or her private physician except in those facili- 
ties affiliated with medical teaching programs and having 
written policies requiring all patients to participate in the 
medical teaching program. 

fb) The private physician shall fulfill given requirements 
as determined by a pplicable state and federal regulations, 
and the facility's policies and procedures pertaining to 
physician services. 

(c) The facility shall have the right, after informing the 
patient, to seek an alternative physician, when requirements 
are not being met and to ensure that the patient is provided 
with appropriate, adequate care and treatment. 

Statutory Authority G.S. 131E-104. 

.2503 USE OF NURSE PRACTITIONERS AND 
PHYSICIAN ASSISTANTS 

(a) If a facility employs physician assistants or nurse 
practitioners it shall maintain the following information for 
each nurse practitioner and physician assistant: 

(P a statement of a pproval to practice as a nurse 
practitioner by the Board of Medical Examiners 
and Board of Nursing for each practitioner, or a 
statement of a pproval to practice as a physician 
assistant by the Board of Medical Examiners for 
each physician assistant; 

(2) an approved annual renewal form; and 

(3) a copy of instructions or protocols signed by the 
nurse practitioner or physician assistant and the 
supervising physicians. 

fb) The privileges of the nurse practitioner or physician 
assistant shall be clearly defined by the facility's policies 
and procedures and shall be limited to those privileges 
authorized in 21 NCAC 32M for the nurse practitioner or 
21 NCAC 32Q for the physician assistant which are hereby 
incorporated by reference including subsequent amendments. 
Copies of the rules may be obtained from the North Caro- 
lina Board of Medical Examiners, PO Box 20007, 1203 
Front Street, Raleigh, NC 27619, at no charge. 

Statutory Authority G.S. 131E-104. 

.2504 LABORATORY AND RADIOLOGY 
SERVICES 

The facility shall provide or obtain clinical laboratory and 



« 



101 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



radiology services to ensure that each patient's needs are 
met. Such services shall include the following: 
(1) provision of laboratory and radiology services 

within the facility or by contractual agreement; 
£2) diagnostic testing to be don e only in accordance 
with a physician's order; 

(3) reports to be dated once filed in the patient's 
medical record: 

(4) notification of the physician regarding findings; 
and 

(5) assistance in arranging transportation for the 
patient when testing must be done other than in 
the facility. 

Statutory Authority G.S. 131E-104. 

.2505 BRAIN INJURY LONG-TERM CARE 
PHYSICIAN SERVICES 

(a) For facility patients located in designated brain injury 
long-term care units, there shall be an attending physician 
who is responsible for the patient's specialized care pro- 
gram. The intensity of the program requires that there shall 
be direct patient contact by a physician at least once per 
week and more often as the patient's condition warrants. 
Each patient's interdisciplinary, rehabilitation program shall 
be developed and implemented under the supervision of a 
phvsiatrist £a physician trained in physical medicine and 
rehabilitation) or a physician of equivalent training and 
experience. 

£b) If a phvsiatrist or physician of equivalent training or 
experience is not available on a weekly basis to the facility, 
the facility shall provide for weekly medical management of 
the patient b y another physician. In addition, oversight for 
the patient's interdisciplinary, long-term care program shall 
be provided by a qualified consultant physician who visits 
patients monthly, makes recommendations for and a pproves 
the interdisciplinary care plan, and provides consultation as 
requested to the physician who is managing the patient on a 
weekly basis. 

(c) The attending physician shall actively participate in 
individual case conference or care planning sessions and 
shall review and sign discharge summaries and records 
within 15 days of a patient discharge. When patients are to 
be discharged to either another health care facility or a 
residential setting, the attending physician shall ensure that 
the patient has been provided with a discharge plan which 
incorporates optimum utilization of community resources 
and post discharge continuity of care and services. 

Statutory Authority G.S. 131E-104. 

.2506 PHYSICIAN SERVICES FOR VENTILATOR 
DEPENDENT PATIENTS 

Facilities with ventilator dependent care patients shall 
contract with a physician who has specialized training in 
pulmonary medicine. This physician shall be responsible 
for respiratory services and shall: 



ill 



(1) 
£4} 



establish, with the respiratory therapist and nurs- 
ing staff, a ppropriate ventilator policies and 
procedures, including emergency procedures; 
assess each ventilator-dependent patient's status at 
least monthly with corresponding progress notes; 
be available on a emergency basis; and 
participate in individual patient care planning. 



Statutory Authority G.S. 131E-104. 

SECTION .2600 - PHARMACEUTICAL SERVICES 

.2601 AVAILABHJTY OF PHARMACEUTICAL 
SERVICES 

(a) The facility shall provide pharmaceutical services 
under the supervision of a qualified pharmacist, including 
procedures that ensure the accurate acquiring, receiving and 
administering of all drugs and biologicals. 

(b) The facility shall be responsible for obtaining drugs, 
therapeutic nutrients and related products prescribed or 
ordered by a physician for patients in the facility. 

(c) To ensure that drug therapy is rational, safe and 
effective, a pharmaceutical care assessment shall be con- 
ducted in the facility at least every 31 days for each patient. 
All new admissions shall receive a pharmaceutical care 
assessment at the time of the pharmacist's next visit or 
within 31 days, whichever comes first. This assessment 
shall include at least: 

(1) a review of the patient's diagnoses, history and 
physical, discharge summary, diet, vital signs, 
current physician's orders, laboratory values, 
progress notes, interdisciplinary care plans and 
medication administration records; and 

(2) the pharmacist's progress notes in the patient's 
medical record which reflect the results of this 
assessment and, if necessary, recommendations 
for change based on desired drug outcomes. 

Statutory Authority G.S. 13 IE- 104. 

.2602 PHARMACY PERSONNEL 

(a) If the pharmacist is an employee of the facility and 
performs vending or clinical services, an up-to-date job 
description and personnel file shall be maintained. 

(b) If pharmaceutical vending or clinical services are 
contracted, there shall be a current written agreement for 
each service which includes a statement of responsibilities 
for each party. 

(c) The facility shall keep, or be able to make available. 
a copy of the current license of the pharmacists. 

Statutory Authority G.S. 13 IE- 104. 

.2603 ADMINISTRATIVE RESPONSIBILITIES 

(a) The pharmacist shall report any potential drug therap y 
irregularities or discrepancies in drug accountability and 
administration with recommendations for change to the 



10:2 



NORTH CAROLINA REGISTER 



April 17, 1995 



102 



PROPOSED RULES 



director of nursing and the attending physician. Recommen- 
dations shall be communicated to the health care profession- 
als in the facility who have the authority to effect a change. 
These reports shall be submitted monthly following the 
pharmacist's pharmaceutical care assessments. 

(b) The administrator shall ensure documentation of 
action taken relative to the pharmacist's reports. 

Statutory Authority G.S. 13 IE- 104. 

.2604 DRUG PROCUREMENT 

(a) The facility shall not be permitted to possess a stock 
of prescription legend drugs for general or common use 
except as permitted by the North Carolina Board of Phar- 
macy and as follows: 



UU 



Ml 

15] 
16} 



for all intravenous and irrigation solutions in 

single unit quantities exceeding 49 ml. and 

related equipment for the use and administration 

of such; 

diagnostic agents; 

vaccines; 

drugs designated for inclusion in an a pproved 

emergency kit; 

water for injection; and 

normal saline for injection. 



(b) Patient Drugs: 

(1) The contents of all prescriptions shall be kept in 
the original container bearing the original label 
as described in Subparagraph (b)(2) of this Rule. 

(2) Except in a 72-hour or less unit dose system. 
each individual patient's prescription or legend 
drugs shall be labeled with the following infor- 
mation: 

(A) the name of the patient for whom the drug is 
intended: 

(B) the most recent date of issue; 

(C) the name of the prescriber; 

(D) the name and concentration of the drug, quan- 
tity dispensed, and prescription serial number; 

(E) a statement of generic equivalency which shall 
be indicated if a brand other than the brand 
prescribed is dispensed; 

(F) the expiration date, unless dispensed in a 
single unit or unit dose package; 
auxiliary statements as required of the drug; 
the name, address and telephone number of the 
dispensing pharmacy; and 
the name of the dispensing pharmacist. 

(c) Non-legend drugs shall be kept in the original con- 
tainer as received from the supplier and shall be labeled as 
described in Subparagraph (b)(2) of this Rule or with at 
least: 

(1) the name and concentration of the drug, and 
quantity packaged; 

(2) the name of the manufacturer, lot number and 
expiration date. 

Statutory Authority G.S. 13 IE- 104. 



10} 

m 

CD 



.2605 DRUG STORAGE AND DISPOSITION 

(a) The pharmacist and director of nursing shall ensure 
that drug storage areas are clean, secure, well lighted and 
well ventilated; that room temperature is maintained between 
59 degrees F. and 86 degrees F.; and that the following 
conditions are met: 

(1) All drugs shall be maintained under locked 
security except when under the immediate or 
direct physical supervision of a nurse or pharma- 
cist. 

(2) Drugs requiring refrigeration shall be stored in 
a refrigerator containing a thermometer and 
capable of maintaining a temperature range of 2 
degrees C to 8 degrees C. (36 degrees F. to 46 
degrees F.) Drugs shall not be stored in a 
refrigerator containing non-drug s and non-drug 
related items, except when stored in a separate 
container. 

(3) Drugs intended for topical use, except for oph- 
thalmic, otic and transdermal medications, shall 
be stored in a designated area separate from the 
drugs intended for oral and injectable use. 

(4) Drugs that are outdated, discontinued or deterio- 
rated shall be removed from the facility within 
five days. 

(b) Upon discontinuation of a drug or upon discharge of 
a patient, the remainder of the drug supply shall be disposed 
of promptly. If it is reasonably expected that the patient 
shall return to the facility and that the drug therapy will be 
resumed, the remaining drug supply may be held for not 
more than 30 calendar day s after the date of discharge or 
discontinuation. 

(c) The disposition of drugs shall be in accordance with 
written policies and procedures established by the Quality 
Assurance Committee. 

(d) Destruction of controlled substances shall be in 
compliance with North Carolina Controlled Substance Act 
and Regulations (10 NCAC 45G) which is hereby incorpo- 
rated by reference including subsequent amendments. 
Copies of the rules may be obtained from the Controlled 
Substances Regulatory Branch. Division of Mental Health. 
Developmental Disabilities and Substance Abuse Services. 
325 N, Salisbury Street. Raleigh. NC 27603 at a cost of 
thirteen dollars ($13.00). 

Statutory Authority G.S. 131E-104. 

.2606 PHARMACEUTICAL RECORDS 

(a) The pharmacist shall ensure that accurate records of 
the receipt, use and disposition of drugs are maintained and 
readily available. 

(b) The director of nursing and pharmacist shall ensure 
accountability of controlled substances as defined by the 
North Carolina Controlled Substances Act and Regulations 
(10 NCAC 45G) which is hereby incorporated by reference 
including subsequent amendments. Copies of the rules may 
be obtained from the Controlled Substances Regulatory 



♦ 



103 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



Branch. Division of Mental Health. Developmental Disabili- 
ties and Substance Abuse Services. 325 N. Salisbury Street. 
Raleigh. NC 27603 at a cost of thirteen dollars ($13.00). 

Statutory Authority G.S. 13 IE- 104. 

.2607 EMERGENCY DRUGS 

(a) The facility shall maintain a supply of emergency 
drugs in compliance with 21 NCAC 46 .1403 which is 
hereby incorporated by reference including subsequent 
amendments. Copies of the rule may be obtained from the 
North Carolina Board of Pharmacy. P.O. Box 459. 
Carrboro Plaza. Highway 54 Bypass. Carrboro. North 
Carolina 27510 at a cost of eight dollars and forty eight 
cents ($8.48). 

(b) Emergency drugs shall be stored in a portable 
container sealed with an easily breakable closure which 
cannot be resealed or reused and shall be readily accessible 
for use. 

(c) Emergency drug kits shall be stored in a secure area 
out of site of patients and the general public. If stored in a 
locked area the kits shall be immediately accessible to all 
licensed nursing personnel. 

(d) All emergency drugs and quantity to be maintained 
shall be a pproved by the Quality Assurance Committee. 

(e) If emergency drug items require refrigerated storage, 
they shall be stored in a separate sealed container within the 
medication refrigerator. The container shall be labeled to 
indicate the emergency status of the enclosed drug and 
sealed as indicated in Paragraph (b) of this Rule.' 

(f) An accurate inventory of emergency drugs and 
su pplies shall be maintained with each emergency drug kit. 

(g) The pharmacist shall personally examine the refriger- 
ated and non-refrigerated emergency drug supply at least 
every 90 days and make any necessary changes at that time. 

(h) The facility shall have written policies and procedures 
which are enforced to ensure that in the event the sealed 
emergency drug container is opened and contents utilized, 
immediate steps are taken to replace the items used. 

(T) The availability of a controlled substance in an 
emergency kit shall be in compliance with the North 
Carolina Controlled Substances Act and Regulations (10 
NCAC 45G) which is hereby incorporated by reference 
including subsequent amendments. Copies of the rules may 
be obtained from the Controlled Substances Regulatory 
Branch. Division of Mental Health. Developmental Disabili- 
ties and Substance Abuse Services. 325 N^ Salisbury Street. 
Raleigh. NC 27603 at a cost of thirteen dollars ($13.00). 

Statutory Authority G.S. 131E-104. 

SECTION .2700 - DIETARY SERVICES 

.2701 PROVISION OF NUTRITION AND DD2TETIC 
SERVICES 

(a) The facility shall ensure that each patient is provided 
with a palatable diet that meets his or her daily nutritional 



and specialized nutritional needs. 

(b) The facility shall designate a person to be known as 
the director of food service who shall be responsible for the 
facility's dietetic service and for supervision of dietetic 
service personnel. If this person is not a dietitian, he or she 
shall meet the criteria for membership in the Dietary 
Managers Association which is hereby incorporated by 
reference including subsequent amendments and editions- 
Copies of criteria may be obtained from the Dietary Manag- 
ers Association. I Pierce Place. Suite 1220 West. Itasca. 
Illinois. 60143 at no cost. If the course has not been 
completed, this person shall be enrolled in a course and 
making satisfactory progress for completion within the time 
limit specified by course requirements. 

(c) If the food service supervisor is not a dietitian, the 
facility shall employ a dietitian on at least a consultant basis. 
The consultant shall submit written reports to the Adminis- 
trator and food service supervisor. 

(d) The dietitian shall spend sufficient time in the facility 
to assure the following parameters of nutrition have been 
addressed and that recommended interventions meet stan- 
dards of practice: 

(1) An analysis of weight loss or gain: 
Laboratory values: 
Clinical indicators of malnutrition: 



£21 

01 
£41 



Drug therapy that may contribute to nutritional 
deficiencies: 

(5) The amount of meal and supplement consumed 
to meet nutritional needs: 

(6) Increased nutritional needs related to disease 
state or deterioration in physical or mental 
status, i.e.. decubitus, low protein status, inade- 
quate intake, or nutrition provided via enteral or 
parenteral route. 

(e) There shall be sufficient dietet ic personnel employed 
competent to meet the nutritional needs of all patients in the 
areas of therapeutic diets, food preparation and service. 
principles of sanitation, and resident's rights as related to 
food services. 

(f) The facility shall ensure that menus are followed 
which meet the nutritional needs of patients in accordance 
with the recommended dietary allowances of the Food and 
Nutrition Board of the National Research Council. National 
Academy of Sciences which are incorporated by reference, 
including subsequent amendments. Copies of this publica- 
tion can be obtained by contacting Printing and Publishing 
Office. National Academy of Sciences. 2101 Constitution 
Avenue. Washington. D.C. Cost of this publication is 
eighteen dollars and ninety five cents ($18.95) and includes 
shi pping and handling. Menus shall: 

(1) be planned at least 14 days in advance. 

(2) provide for substitutes of similar nutritive value 
for patients who refuse food that is served, and 

(3) be posted weekly for patient's review. 

(g) Food must be prepared to conserve its nutritive value 
and appearance. 

(h) Food shall be served at the a ppropriate temperature, in 



10:2 



NORTH CAROLINA REGISTER 



April 17, 1995 



104 



PROPOSED RULES 



the form to meet the patient's individual needs and with 
assistive devices as dictated by the patient's needs. The 
following temperatures are acceptable upon patient receipt: 

(1) Hot liquids 150 degrees (minimum) 

(2) Hot cereal 150 degrees (minimum) 

(3) Soups 130 degrees (minimum) 

(4) Hot foods 110 degrees (minimum) 

(5) Cold liquids 50 degrees (maximum) 

(6) Cold foods 65 degrees (maximum) 

(i) If patients require assistance in eating, food shall be 
maintained at serving temperature until assistance is pro- 
vided. 

(i) All diets, including enteral and parenteral nutrition 
therapy, shall be ordered by the physician and served as 
ordered. 

(k) At least three meals shall be served daily to all 
patients in accordance with physician orders. 

(1) No more than 14 hours shall elapse between an 
evening meal containing a protein food and a morning meal 
containing a protein food. 

(m) Hour-of-sleep (hs) nourishment shall be available to 
patients upon request or in accordance with nutritional 
plans. 

(n) Between meal fluids for hydration shall be available 
and offered to all patients in accordance with physician 
orders. 

(o) The facility shall have a current nutrition care manual 
or handbook a pproved by the dietitian, medical staff and the 
Administrator which shall be used in the planning of the 
regular and therapeutic diets and be accessible to all staff. 

(p) Food services shall comply with Rules Governing the 
Sanitation of Restaurants and Other Foodhandling Establish- 
ments as promulgated by the Commission for Health 
Services which is incorporated by reference, including 
subsequent amendments, assuring storage, preparation, and 
serving of food under sanitary conditions. Copies of these 
Rules can be obtained, at no charge. by_ contacting the N.C. 
Department of Environment. Health, and Natural Resources. 
Division of Environmental Health. 1330 St. Mary's Street. 
Raleigh. NC 27605-3248. 

Statutory Authority G.S. 13 IE- 104. 

SECTION .2800 - ACTIVITIES, RECREATION 
AND SOCIAL SERVICES 

.2801 ACTIVITY SERVICES 

(a) The facility shall provide a program of activities that 
is on-going and in accordance with the comprehensive 
assessment, and that promotes the interests, as well as 
physical, mental and psychosocial well-being, of each 
patient. 

(b) The administrator shall designate an activities director 
who shall be responsible for activity and recreational 
services for all patients and who shall have a ppropriate 
management authority. The director shall: 

(1) be a recreation therapist or be eligible for certifi- 
cation as a therapeutic recreation specialist by a 



recognized accrediting body; or 

(2) have two years of experience in a social or 
recreation program within the last five years, 
one of which was full-time in a patient activities 
program in a health care setting; or 

(3) be an occupational therapist or occupational 
therapy assistant; or 

(4) be certified by the National Certification Council 
for Activity Professionals; or 

(5) have completed an activities training course 
a pproved by the State. 



Authority G. S. 
483. 15tf). 



131E-104; 143B-165(10); 42 C.F.R. 



.2802 SOCIAL SERVICES 

(a) The facility shall provide medically-related social 
services to attain or maintain the highest practicable physi- 
cal, mental and psychosocial well-being of each resident. 

(b) The administrator shall designate an employee to be 
responsible full-time for social services. 

(c) A facility with more than 120 nursing beds shall 
employ on a full time basis, a social worker who has: 

(1) a Bachelors' degree in social work or a Bache- 
lors' degree in human services field, including 
but not limited to sociology special education, 
rehabilitation counseling and psychology; and 

(2) one year of supervised social work experience in 
a health care setting working directly with 
patients. 

Statutory Authority G.S. 131E-104. 

SECTION .2900 - SPECIAL REQUIREMENTS 

.2901 REPORT OF DEATH 

The facility shall have a written plan to be followed in 
case of patient death. The plan shall provide for the 
following: 

(1) collection of data needed for the death certificate 
as required by G.S. 130A-117; 

(2) recording time of death; 

(3) pronouncement of death in accordance with facil- 
ity policy; 

(4) notification of the attending physician responsible 
for signing the death certificate; 

(5) documented notification of next of kin or legal 
guardian; 

(6) authorization and release of the body to a funeral 
home. 

Statutory Authority G.S. 131E-104. 

.2902 PETS (COMPANION ANIMALS) 

When facility policies permit pets in the facility, the 
following conditions shall be met: 
(1) The facility policy shall not be in violation of any 
local health ordinances regarding pet health and 



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PROPOSED RULES 



control. 
(2) Pets shall not be permitted to enter areas where 
food is being prepared. 

Statutory Authority G.S. 13 IE- 104. 

SECTION .3000 - SPECIALLY DESIGNATED 
UNITS 

.3001 SPECIALIZED REHABmiTATIVE AND 
HABn.ITATIVE SERVICES 

Specialized rehabilitative and habilitative services, such as 
physical therapy, occupational therapy and speech therapy, 
are not required as a condition of licensure. Patients 
requiring such services, however, shall not be admitted or 
retained in a facility unless the facility is capable of furnish- 
ing the needed services. If specialized rehabilitative 
services are provided: 

(1) The facility shall provide or obtain from an out- 
side resource specialized rehabilitative services as 
required by the patient's comprehensive plan of 
care. 

(2) Specialized rehabilitative services shall be ordered 
by the physician and provided by a licensed or 
certified, professional therapist in the area of 
assignment. 

Statutory Authority G.S. 131E-104. 

.3002 QUALITY OF SPECIALIZED 
REHABILITATION SERVICES 

£a) While the person supervising specialized rehabilitative 
and habilitative services shall be a licensed or certified 
professional therapist, all other su pport personnel shall be 
trained in the area of assignment and directly supervised by 
the therapist in the area of assignment. 

(b) Services provided through outside resources shall be 
carried out through, and in accordance with, written 
agreements. 

(c) Services shall be designed to maintain and improve 
the patient's ability to function independently, prevent as 
much as possible the advancement of progressive disabili- 
ties, and restore maximum function. 

(d) If nursing staff carry out selected therapy procedures, 
they shall do so under the supervision of the physical or 
occupational therapist and only after documented training 
and a pproval by the therapist. This is not to prohibit simple 
restorative measures by the nursing staff. 

Statutory Authority G.S. 13 IE- 104. 

.3003 VENTH.ATOR DEPENDENCE 

The general requirements in this Subchapter shall apply 
when applicable. In addition, facilities having patients 
requiring the use of ventilators for more than eight hours a 
day shall meet the following requirements: 

(1) The facility shall be located within 30 minutes of 



(a) 



lb) 
[c] 



an acute care facility. 

(2) Respiratory therapy shall be provided and super- 
vised by a respiratory therapist currently regis- 
tered by the National Board for Respiratory Care. 
The respiratory therapist shall: 

make, as a minimum, weekly on-site assess- 
ments of each patient receiving ventilator sup- 
port with corresponding progress notes; 
be on-call 24 hours daily; and 
assist the pulmonologist and nursing staff in 
establishing ventilator policies and procedures, 
including emergency policies and procedures. 

(3) Direct nursing care staffing shall be in accordance 
with Rule .3005 of this Section. 

Statutory Authority G.S. 131E-104. 

.3004 BRAIN INJURY LONG-TERM CARE 

(a) The general requirements in this Subchapter shall 

apply when a pplicable, but brain injury long term care units 

shall meet the supplement requirements in Rules .3004 and 

.3005 of this Section. The facility shall provide services 

through a medically supervised interdisciplinary process as 

provided in Rule .2505 of this Subchapter and are directed 

toward maintaining the individual at the optimal level of 

physical, cognitive and behavioral functioning. Following 

are the minimum requirements for specific services that may 

be necessary to maintain the individual at optimum level: 

Qj Overall supervisory responsibility for brain 

injury long term care services shall be assigned 

to a registered nurse with one year experience in 

caring for brain injured patients. 

(2) Physical therapy shall be provided by a physical 
therapist with a current valid North Carolina 
license. Occupational therapy shall be provided 
by an occupational therapist with a current valid 
North Carolina License. The services of a 
physical therapist and occupational therapist shall 
be combined to provide one full-time equivalent 
position for each 20 patients. The assistance of 
a physical therapy aide and occupational therapy 
aide, with appropriate supervision, shall be 
combined to provide one full-time equivalent 
position for each 20 patients. A proportionate 
number of hours shall be provided for a census 
less than 20 patients. 

(3) Clinical nutrition services shall be provided by 
a qualified dietitian with two years clinical 
training and experience in nutrition. The num- 
ber of hours of clinical nutrition services on 
either a full-time or part-time employment or 
contract basis shall be adequate to meet the 
needs of the patients. Each patient's nutrition 
needs shall be reviewed at least monthly. Clini- 
cal nutrition services shall include: 

(A) Assessing the appropriateness of the ordered 
diet for conformance with each patient's phvsi- 



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106 



PROPOSED RULES 



ological and pharmacological condition. 

(B) Evaluating each patient's laboratory data in 
relation to nutritional status and hydration. 

(C) A pplying technical knowledge of feeding 
tubes, pumps and equipment to each patient's 
specialized needs. 

£4} Clinical social work shall be provided by a 
social worker meeting the requirements of Rule 
.3002 of this Section. 

(5) Recreation therapy, when required, shall be 
provided on either a full-time or part-time 
employment or contract basis by a clinician 
eligible for certification as a therapeutic recre- 
ation specialist by the State of North Carolina 
Therapeutic Recreational Certification Board. 
The number of hours of therapeutic recreation 
services shall be adequate to meet the needs of 
the patients. In event that a qualified specialist 
is not locally available, alternate treatment 
modalities shall be developed by the occupa- 
tional therapist and reviewed by the attending 
physician. The program designed shall be 
adequate to meet the needs of this specialized 
population and shall be administered in accor- 
dance with Section .3000 of this Subchapter. 

(6) Speech therapy, when required, shall be pro- 
vided by a clinician with a current valid license 
in speech pathology issued by the State Board of 
Audiology and Speech Pathology. 

(7) Respiratory therapy, when required, shall be 
provided by an individual meeting the same 
qualifications for providing respiratory therapy 
under Rule .3003 of this Section. 

(b) Each patient's program shall be governed by an 
interdisciplinary treatment plan incorporating and expanding 
upon the health plan required under Section .2300 of this 
Subchapter. The plan is to be initiated on the first day of 
admission. Upon completion of baseline data development 
and an integrated interdisciplinary assessment, the initial 
treatment plan is to be expanded and finalized within 14 
days of admission. Through an interdisciplinary process the 
treatment plan shall be reviewed at least monthly and 
revised as appropriate. In executing the treatment plan, the 
interdisciplinary team shall be the major decision making 
body and shall determine the goals, process, and time 
frames for accomplishment of each patient's program- 
Disciplines to be represented on the team shall be medicine, 
nursing, clinical pharmacy and all other disciplines directly 
involved in the patient's treatment or treatment plan. 

(c) Each patient's overall program shall be assigned to an 
individually designated case manager. The case manager 
acts as the coordinator for assigned patients. Any profes- 
sional staff member involved in a patient's care may be 
assigned this responsibility for one or more patients. 
Professional staff may divide this responsibility for all 
patients on the unit in the best manner to meet all patients' 
needs for a coordinated, interdisciplinary approach to care. 
This case manager shall be responsible for: 



(1) coordinating the development, implementation 
and periodic review of the patient's treatment 
plan; 

(2) preparing a monthly summary of the patient's 
progress; 

(3) cultivating the patient's participation in the 
program; 

(4) general supervision of the patient during the 
course of treatment; 

(5") evaluating appropriateness of the treatment plan 
in relation to the attainment of stated goals; and 
(6) assuring that discharge decisions and arrange- 
ments for post discharge follow-up are properly 
made. 
(d) For each 20 patients or fraction thereof, dedicated 
treatment facilities and equipment shall be provided as 
follows: 

(1) a combined therapy space equal to or exceeding 
600 square feet, adequately equipped and ar- 
ranged to su pport each of the therapies; 

(2) access to one full reclining wheel chair per 
patient; 

(3) special physical therapy and occupational therapy 
equipment for use in fabricating positioning 
devices for beds and wheelchairs including 
splints, casts, cushions, wedges, and bolsters; 
and 

(4) roll-in bath facilities with a dressing area avail- 
able to all patients, providing maximum privacy 
to the patient. 

Statutory Authority G.S. 13 IE- 104. 

.3005 SPECIAL NURSING REQUIREMENTS FOR 
BRAIN INJURY LONG-TERM CARE 

Direct care nursing personnel staffing ratios established in 
Rule .2303 of this Subchapter shall not be a pplied to nursing 
services for patients who require brain injury long-term 
care. The minimum direct care nursing staff shall be 5.5 
hours per patient day, allocated on a per shift basis as the 



facility chooses, to appropriately meet the patients' needs. 
It is also required that regardless of how low the patient 
census, the direct care nursing staff shall not fall below a 
registered nurse and a nurse aide I at any time during a 
24-hour period. 

Statutory Authority G.S. 13 IE- 104. 

.3006 RESERVED FOR FUTURE CODIFICATION 

.3007 RESERVED FOR FUTURE CODD7ICATION 

.3008 RESERVED FOR FUTURE CODD7ICATION 

.3009 RESERVED FOR FUTURE CODD7ICATION 

.3010 RESERVED FOR FUTURE CODD7ICATION 



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PROPOSED RULES 



.3011 HTV DESIGNATED UNIT POLICES AND 
PROCEDURES 

(a) In units dedicated to the treatment of patients with 
Human Immunodeficiency Virus disease, policies and 
procedures specific to the specialized needs of the patients 
served shall be developed. At a minimum they shall include 
staff training and education, and the availability of consulta- 
tion by a physician with specialized education or knowledge 
in the management of Human Immunodeficiency Virus 
disease. 

(b) Policies and procedures for infection control shall be 
in conformance with 29 CFR 1910 (Occupational Safety and 
Health Standards) which is incorporated by reference 
including subsequent amendments. Emphasis shall be 
placed on compliance with 29 CFR 1910-1030 (Bloodborne 
Pathogens). Copies of Title 29 Part 1910 may be purchased 
from the Superintendent of Documents. U.S. Government 
Printing Office. Washington. D.C. 20402 for thirty eight 
dollars ($38.00) or may be purchased with a credit card by 
telephoning the Government Printing Office at (202) 
783-3238. Infection control shall also be in compliance with 
the Center of Disease Control Guidelines as published by 
the U.S. Department of Health and Human Services. Public 
Health Service, which is incorporated by reference, includ- 
ing subsequent amendments. Copies may be purchased 
from the National Technical Information Service. U.S. 
Department of Commerce. 5285 Port Royal Road. Spring- 
field. Virginia 22161 for fifteen dollars and ninety five cents 
($15.95). 

Statutory Authority G.S. 131E-104. 

.3012 PHYSICIAN SERVICES IN AN HTV 
DESIGNATED UNIT 

In a facility with a Human Immunodeficiency Virus 
designated unit, the facility shall ensure that attending 
physicians have documented, prearranged access in person 
or b_Y telephone to a physician with specialized education or 
knowledge in the management of Human Immunodeficiency 
Virus disease. 

Statutory Authority G.S. 131E-104. 

.3013 SPECIAL NURSING REQWREMENTS FOR 
AN HTV DESIGNATED UNIT 

(a) A facility with a Human Immunodeficiency Virus 
designated unit shall have a registered nurse with specialized 
education or knowledge in the care of Human Immunodefi- 
ciency Virus disease. 

(b) Nursing personnel assigned to the Human Immunode- 
ficiency Virus unit shall be regularly assigned to the unit- 
Periodic rotations are acceptable. 



A facility with a Human Immunodeficiency Virus de sig- 
nated unit shall provide an organized, documented program 
of education specific to the care of patients infected with the 
Human Immunodeficiency Virus, including at a minimum: 
(1) Human Immunodeficiency Virus and Acquired 
Immune Deficiency Syndrome disease processes; 
transmission modes, causes, and prevention of 
Human Immunodeficiency Virus; 
treatment of Human Immunodeficiency Virus and 
Acquired Immune Deficiency Syndrome; 
psycho-socio-economic needs of the Human 
Immunodeficiency Virus and Acquired Immune 
Deficiency Syndrome patients; 
universal precautions and infection control; and 
policies and procedures specific to the Human 
Immunodeficiency Virus designated unit. 



£21 
£3} 



£4} 



£5} 
£6} 



Statutory Authority G.S. 13 IE- 104. 

.3015 USE OF INVESTIGATIONAL DRUGS FOR 
HTV DESIGNATED UNITS 

(a) The supervision and monitoring for the administration 
of investigational drugs is the responsibility of the pharma- 
cist and a registered nurse, acting pursuant to the orders of 
a physician authorized to prescribe or dispense such drugs. 
Responsibilities shall include, but not be limited to. the 
following: 

(1) insuring the provision of written guidelines for 
any investigational drug or study; and 

(2) training and determination of staffs abilities 
regarding administration of drugs, policies, 
procedures and regulations. 

(b) The pharmacist or physician dispensing the investiga- 
tional drug is to provide the facility with information 
regarding at least the following: 

(1) a copy of the protocol, including drug informa- 
tion; 

(2) a copy of the patient's informed consent; 

(3) drug storage; 

(4) handling; 

(5) any specific preparation and administration 
instructions; 

(6) specific details for drug accountability, resupply 
and return of unused drug; and 

(7) a copy of the signed consent to participate in the 
study. 

(c) Labeling of investigational drugs shall be in accor- 
dance with written guidelines of protocol and State and 
federal requirements regarding such drugs. Prescription 
labels for investigational drugs are to be distinguishable 
from other labels by an a ppropriate legend. "Investigational 
Drug" or "For Investigational Use Only." 



Statutory Authority G.S. 131E-104. 



Statutory Authority G.S. 131E-104. 



.3014 SPECIALIZED STAFF EDUCATION FOR HTV 
DESIGNATED UNITS 



.3016 ADDITIONAL SOCIAL WORK 

REQUIREMENTS FOR HTV DESIGNATED 



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108 



PROPOSED RULES 



UNITS 

In addition to the social work services specified in Rule 
.3002 of this Section, in a facility with a Human Immunode- 
ficiency Virus disease designated unit, the social worker 
shall provide or arrange for the provision of spiritual, 
pastoral and grief counseling and bereavement services for 
patients and staff where appropriate. Su pport services shall 
be provided to the patients' families and significant others. 
Where necessary, coordination with treatment services for 
substance abuse, legal services and other community 
resources shall be identified. 

Statutory Authority G.S. 13 IE- 104. 

.3017 RESERVED FOR FUTURE CODIFICATION 

.3018 RESERVED FOR FUTURE CODDJICATION 

.3019 RESERVED FOR FUTURE CODIFICATION 

.3020 RESERVED FOR FUTURE CODIFICATION 

.3021 PHYSICIAN REQWREMENTS FOR 
INPATIENT REHABILITATION 
FACILnTES OR UNITS 

(a] In a rehabilitation facility or unit a physician shall 
participate in die provision and management of rehabilitation 
services and in the provision of medical services. 

£b) In a rehabilitation facility or unit a rehabilitation 
physician shall be responsible for a patient's interdisciplin- 
ary treatment plan. Each patient's interdisciplinary treat- 
ment plan shall be developed and implemented under the 
supervision of a rehabilitation physician. 

(c) The rehabilitation physician shall participate in the 
preliminary assessment within 48 hours of admission, 
prepare a plan of care and direct the necessary frequency of 
contact based on the medical and rehabilitation needs of the 
patient. The frequency shall be appropriate to justify the 
need for comprehensive inpatient rehabilitation care. 

(d) An inpatient rehabilitation facility or unit's contract or 
agreements with a rehabilitation physician shall require that 
the rehabilitation physician shall participate in individual 
case conferences or care planning sessions and shall review 
and sign discharge summaries and records. When patients 
are to be discharged to another health care facility, the 
discharging facility shall ensure that the patient has been 
provided with a discharge plan which incorporates post 
discharge continuity of care and services. When patients are 
to be discharged to a residential setting, the facility shall 
ensure that the patient has been provided with a discharge 
plan that incorporates the utilization of community resources 
when available and when included in the patient's plan of 
care. 

(e) The intensity of physician medical services and the 
frequency of regular contacts for medical care for the 
patient shall be determined by the patieni's pathophysiologic 
needs. 

(f) Where the attending physician of a patient in an 



inpatient rehabilitation facility or unit orders medical 
consultations for the patient, such consultations shall be 
provided by qualified physicians within 48 hours of the 
physician's order. In order to achieve this result, the 
contracts or agreements between inpatient rehabilitation 
facilities or units and medical consultants shall require that 
such consultants render the requested medical consultation 
within 48 hours. 

(g) An inpatient rehabilitation facility or unit shall have 
a written procedure for setting the qualifications of the 
physicians rendering physical rehabilitation services in the 
facility or unit. 

Statutory Authority G.S. 13 IE- 104. 

.3022 ADMISSION CRITERIA FOR INPATDZNT 
REHABILITATION FACILITIES OR UNITS 

(a) The facility shall have written criteria for admission 
to the inpatient rehabilitation facility or unit. A description 
of programs or services for screening the suitability of a 
given patient for placement shall be available to staff and 
referral sources. 

fb) For patients found unsuitable for admission to the 
inpatient rehabilitation facility or unit, there shall be 
documentation of the reasons. 

(c) Within 48 hours of admission a preliminary assess- 
ment shall be completed by members of the interdisciplinary 
team to ensure the a ppropriateness of placement and to 
identify the immediate needs of the patient. 

(d) Patients admitted to an inpatient rehabilitation facility 
or unit must be able to tolerate a minimum of three hours of 
rehabilitation therapy, five days a week, including at least 
two of the following rehabilitation services: physical 
therapy, occupational therapy or speech therapy. 

(e) Patients admitted to an inpatient rehabilitation facility 
or unit must be medically stable, have a prognosis indicating 
a progressively improved medical condition and have the 
potential for increased independence. 

Statutory Authority G.S. 13 IE- 104. 

.3023 COMPREHENSIVE INPATIENT 

REHABILITATION EVALUATION 

(a) A comprehensive, inpatient rehabilitation evaluation 
is required for each patient admitted to an inpatient rehabili- 
tation facility or unit. At a minimum this evaluation shall 
include the reason for referral, a summary of the patient's 
clinical condition, functional strengths and limitations, and 
indications for specific services. This evaluation shall be 
completed within three days. 

(b) Each patient shall be evaluated by the interdisciplinary 
team to determine the need for any of the following ser- 
vices: medical, dietary, occupational therapy, physical 
therapy, prosthetics and orthotics, psychological assessment 
and therapy, therapeutic recreation, rehabilitation medicine, 
rehabilitation nursing, therapeutic counseling or social work, 
vocational rehabilitation evaluation and speech-language 
pathology. 



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PROPOSED RULES 



Statutory Authority G.S. 13 IE- 104. 

.3024 COMPREHENSIVE INPATIENT 

REHABILITATION INTERDISCIPLINARY 
TREAT/PLAN 

(a) The interdisciplinary treatment team shall develop an 
individual treatment plan for each patient within seven days 
after admission. The plan shall include evaluation findings 
and information about the following: 

(1) prior level of function; 

(21 current functional limitations: 

(3) specific service needs: 

(4) treatment, su pports and adaptations to be pro- 
vided: 

(5) specified treatment goals; 

(6) disciplines responsible for implementation of 
separate parts of the plan; and 

£7} anticipated time frames for the accomplishment 
of specified long-term and short-term goals. 
Co) The treatment plan shall be reviewed by the interdisci- 
plinary team at least every other week. All members of the 
interdisciplinary team, or a representative of their discipline, 
shall attend each meeting. Documentation of each review 
shall include progress toward defined goals and identifica- 
tion of any changes in the treatment plan. 

(c) The treatment plan shall include provisions for all of 
the services identified as needed for the patient in the 
comprehensive inpatient rehabilitation evaluation completed 
in accordance with Rule .3023 of this Section- 
al Each patient shall have a designated case manager 
who is responsible for the coordination of the patient's 
individualized treatment plan. The case manager is respon- 
sible for promoting the program's responsiveness to the 
needs of the patient and shall participate in all team confer- 
ences concerning the patient's progress toward the accom- 
plishment of specified goals. Any of the professional staff 
involved in the patient's care may be the designated case 
manager for one or more cases, or the director of nursing 
or social worker may accept the coordination responsibility 
for the patients. 

Statutory Authority G.S. 131E-104. 

.3025 DISCHARGE CRITERIA FOR INPATIENT 
REHABILITATION FACILITDZS OR UNITS 

(a) Discharge planning shall be an integral part of the 
patient's treatment plan and shall begin upon admission to 
the facility. After established goals have been reached, or 
a determination has been made that care in a less intensive 
setting would be a ppropriate, or that further progress is 
unlikely, the patient shall be discharged to an appropriate 
setting. Other reasons for discharge may include an 
inability or unwillingness of patient or family to cooperate 
with the planned therapeutic program or medical complica- 
tions that preclude a further intensive rehabilitative effort. 
The facility shall involve the patient, family, staff members 
and referral sources in discharge planning. 



(b) The case manager shall facilitate the discharge or 
transfer process in coordination with the facility social 
worker. 

(c) If a patient is being referred to another facility for 
further care, a ppropriate documentation of the patient's 
current status shall be forwarded with the patient. A formal 
discharge summary shall be forwarded within 48 hours 
following discharge and shall include the reasons for 
referral, the diagnosis, functional limitations, services 
provided, the results of services, referral action recommen- 
dations and activities and procedures used by the patient to 
maintain and improve functioning. 

Statutory Authority G.S. 131-104. 

.3026 COMPREHENSIVE REHABILITATION 
PERSONNEL ADMINISTRATION 

(a) The facility shall have qualified staff members, 
consultants and contract personnel to provide services to the 
patients admitted to the inpatient rehabilitation facility or 
unit. 

Co) Personnel shall be employed or provided by contrac- 
tual agreement in sufficient types and numbers to meet the 
needs of all patients admitted for comprehensive rehabilita- 
tion. 

(c) Written agreement shall be maintained by the facility 
when services are provided by contract on an ongoing basis. 

Statutory Authority G.S. 131E-104. 

.3027 COMPREHENSIVE INPATIENT 
REHABILITATION PROGRAM 
STAFFING REQUIREMENTS 

(a) The staff of the inpatient rehabilitation facility or unit 
shall include at a minimum: 

(1) The inpatient rehabilitation facility or unit shall 
be supervised by a rehabilitation nurse. The 
facility shall identify the nursing skills necessary 
to meet the needs of the rehabilitation patients in 
the unit and a ssign staff qualified to meet those 
needs. 

(2) The minimum nursing hours per patient in the 
rehabilitation unit shall be 5.5 nursing hours per 
patient day. At no time shall direct care nursing 
staff be less than two full-time equivalents, one 
of which shall be a registered nurse. 

(3} The inpatient rehabilitation unit shall employ or 
provide by contractual agreements sufficient 
therapists to provide a minimum of three hours 
of specific (physical . occupational or speech) or 
combined rehabilitation therapy services per 
patient day. 

(4) Physical therapy assistants and occupational 
therapy assistants shall be supervised on-site by 
physical therapists or occupational therapists. 

(5) Rehabilitation aides shall have documented 
training appropriate to the activities to be per- 



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110 



PROPOSED RULES 



formed and the occupational licensure laws of 
his or her supervisor. The overall responsibility 
for the on going supervision and evaluation of 
the rehabilitation aide remains with the regis- 
tered nurse as identified in Subparagraph (aid) 
of this Rule. Supervision by the physical thera- 
pist or by the occupational therapist is limited to 
that time when the therapist is on-site and direct- 
ing the rehabilitation activities of the aide. 
(6) Hours of service by the rehabilitation aide are 
counted toward the required nursing hours when 
the aide is working under the supervision of the 
nurse. Hours of service by the rehabilitation 
aide are counted toward therapy hours during 
that time the aide works under the immediate, 
on-site supervision of the physical therapist or 
occupational therapist. Hours of service shall 
not be dually counted for both services. Hours 
of service by rehabilitation aides in performing 
nurse-aide duties in areas of the facility other 
than the rehabilitation unit shall not be counted 
toward the 5.5 hour minimum nursing require- 
ment described for the rehabilitation unit, 
(b) Additional personnel shall be provided as required to 
meet the needs of the patient, as defined in the comprehen- 
sive inpatient rehabilitation evaluation. 

Statutory Authority G.S. 13 IE- 104. 

.3028 STAFF TRAINING FOR INPATIENT 
REHABILITATION FACILITIES OR 
UNIT 

Prior to the provision of care, all rehabilitation personnel, 
excluding physicians, assigned to the rehabilitation unit shall 
be provided training or shall provide documentation of 
training that includes at a minimum the following: 
(1) active and passive range of motion; 
assistance with ambulation; 
transfers; 



m 

£2} 
£4} 
(5) 

m 

m 

m 

m 

(10) 

OD 

(12) 



maximizing functional independence; 

the psycho-social needs of the rehabilitation 

patient; 

the increased safety risks of rehabilitation training 

including falls and the use of restraints; 

proper body mechanics; 

nutrition, including dysphagia and restorative 

eating; 

communication with the aphasic and hearing 

impaired patient; 

behavior modification: 

bowel and bladder training; and 

skin care. 



Statutory Authority G.S. 131E-104. 

.3029 EQUIPMENT REQS/COMPREHENSIVE 
INPATIENT REHABILITATION 
PROGRAMS 



(a) The facility shall provide each discipline with the 
necessary equipment and treatment methods to achieve the 
short and long-term goals specified in the comprehensive 
inpatient rehabilitation interdisciplinary treatment plans for 
patients admitted to these facilities or units. 

(b) Each patient's needs for a standard wheelchair or a 
specially designed wheelchair or additional devices to allow 
safe and independent mobility within the facility shall be 
met. 

(c) Special physical therapy and occupational therapy 
equipment for use in fabricating positioning devices for beds 
and wheelchairs shall be provided, including splints, casts, 
cushions, wedges and bolsters. 

(d) Physical therapy devices shall be provided, including 
a mat table, parallel bars, sliding boards and special 
adaptive bathroom equipment. 

Statutory Authority G.S. 13 IE- 104. 

.3030 PHYSICAL FACILITY REQS/INPATIENT 
REHABILITATION FACILITIES OR UNIT 

(a) The inpatient rehabilitation facility or unit shall be in 
a designated area and shall be used for the specific purpose 
of providing a comprehensive inpatient rehabilitation 
program. 

(b) The floor area of a single bedroom shall be sufficient 
for the patient or the staff to easily transfer the patient from 
the bed to a wheelchair and to maneuver a 180 degree turn 
with a wheelchair on at least one side of the bed. 

(c) The floor area of a multi-bed bedroom shall be 
sufficient for the patient or the staff to easily transfer the 
patient from the bed to a wheelchair and to maneuver a 180 
degree turn with a wheelchair between beds. 

(d) Each patient room shall meet the following require- 
ments: 

(1) Maximum room capacity of no more than four 
patients; 

(2) Operable windows: 

(3) A nurse call system designed to meet the special 
needs of rehabilitation patients: 

(4) In single and two-bed rooms with private toilet 
room, the lavatory may be located in the toilet 
room; 

(5) A wardrobe or closet for each patient which is 
wheelchair accessible and arranged to allow the 
patient to access the contents; 

(6) A chest of drawers or built-in drawer storage 
with mirror above, which is wheelchair accessi- 
ble; and 

(7") A bedside table for toilet articles and personal 
belongings. 

(e) Space for emergency equipment such as resuscitation 
carts shall be provided and shall be under direct control of 
the nursing staff, in proximity to the nurse's station and out 
of traffic. 

(f) Patients' bathing facilities shall meet the following 
specifications: 

(1) There shall be at least one shower stall or one 



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PROPOSED RULES 



bathtub for each 15 beds not individually served. 
Each tub or shower shall be in an individual 
room or privacy enclosure which provides space 
for the private use of the bathing fixture, for 
drying and dressing and for a wheelchair and an 
assisting attendant. 

(2) Showers in central bathing facilities shall be at 
least five feet square without curbs and designed 
to permit use by a wheelchair patient. 

(3) At least one five-foot-bv-seven-foot shower shall 
be provided which can accommodate a stretcher 
and an assisting attendant. 

(g) Patients' toilet rooms and lavatories shall meet the 
following specifications: 

(1) The size of toilet rooms shall permit a wheel- 
chair, a staff person and appropriate 
wheel-to-water closet transfers. 

(2) A lavatory in the room shall permit wheelchair 
access. 

(3) Lavatories serving patients shall: 

(A) allow wheelchairs to extend under the lavatory; 
and 

(B) have water supply spout mounted so that its 
discharge point is a minimum of five inches 
above the rim of the fixture. 

(4) Lavatories used by patients and by staff shall be 
equipp ed with blade-operated supply valves. 

(h) The space provided for physical therapy, occupational 
therapy and speech therapy by all inpatient rehabilitation 
facilities or units may be shared but shall, at a minimum, 
include: 

(1) office space for staff: 

(2) office space for speech therapy evaluation and 
treatment: 

(3) waiting space: 

(4) training bathroom which includes toilet, lavatory 
and bathtub: 

gymnasium or exercise area: 
work area such as tables or counters suitable for 
wheelchair access: 

treatment areas with available privacy curtains 
or screens: 



£51 

£61 
£21 
£S1 



an activities of daily living training kitchen with 
sink, cooking top (secured when not supervised 
by staff), refrigerator and counter surface for 
meal preparation: 
£21 storage for clean linens, supplies and equipment: 

(10) janitor's closet accessible to the therapy area 
with floor receptor or service sink and storage 
space for housekeeping su pplies and equipment, 
with one closet or space serving more than one 
area of the inpatient rehabilitation facility or unit 
as needed: and 

(11) hand washing facilities. 

£il For social work and psychological services the 
following shall be provided: 
(1) office space for staff: 



(2) office space for private interviewing and coun- 
seling for all family members: and 

(3) work space for testing, evaluation and counsel- 
ing. 

(jl If prosthetics and orthotics services are provided, the 
following space shall be made available as necessary: 
(1) work space for technician; and 
£21 space for evaluation and fittings (with provisions 
for privacy!. 
(k) If vocational therapy services are provided, the 
following space shall be made available as necessary: 



office space for staff; 

work space for vocational services activities such 

as prevocational and vocational evaluation: 

training space; 

storage for equipment; and 

counseling and placement space. 
(1) Recreational therapy space requirements include the 
following: 

activities space: 

storage for equipment and su pplies; 

office space for staff; and 

access to male and female toilets. 
(m) The following space shall be provided for patient 
dining, recreation and day areas: 



01 
121 

£21 
£41 
£51 



01 
£21 
£21 
£41 



(1) sufficient room for wheelchair movement and 

wheelchair dining seating; 
£21 if food service is cafeteria type, adequate width 
for wheelchair maneuvers, queue space within 
the dining area (and not in a corridor) and a 
serving counter low enough to view food; 
£3_1 total space for inpatients, a minimum of 25 

square feet per bed; 
£41 for outpatients participating in a day program or 
partial day program. 20 square feet when dining 
is a part of the program and 10 square feet when 
dining is not a part of the program; and 
(5) storage for recreational equipment and supplies, 
tables and chairs, 
(n) The patient dining, recreation and day area spaces 
shall be provided with windows that have glazing of an area 
not less than eight percent of the floor area of the space, 
and at least one-half of the required window area must be 
operable. 

(0) A laundry shall be available and accessible for 
patients. 

Statutory Authority G.S. 13 IE- 104. 

.3031 ADDITIONAL REQUIREMENTS FOR 
SPINAL CORD INJURY PATENTS 

Inpatient rehabilitation facilities providing services to 
persons with spinal cord injuries shall meet the requirements 
in this Rule in addition to those identified in this Section. 

(1) Direct-care nursing personnel staffing ratios 
established in Rule .3027 of this Section shall not 
be a pplied to nursing services for spinal cord 



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112 



PROPOSED RULES 



injury patients in the inpatient rehabilitation 
facility or unit. The minimum nursing hours per 
spinal cord injury patient in the unit shall be 6.0 
nursing hours per patient day. At no time shall 
direct care nursing staff be less than two full-time 
equivalents, one of which shall be a registered 
nurse. 

(2) The inpatient rehabilitation facility or unit shall 
employ or provide by contractual agreements 
physical, occupational or speech therapists in 
order to provide a minimum of 4J) hours of 
specific or combined rehabilitation therapy ser- 
vices per spinal cord injury patient day. 

(3) The facility shall provide special facility or special 
equipment needs of patients with spinal cord 
injury, including specially designed wheelchairs, 
tilt tables and standing tables. 

(4) The medical director of an inpatient spinal cord 
injury program shall have either two years experi- 
ence in the medical care of persons with spinal 
cord injuries or six months minimum in a spinal 
cord injury fellowship. 

(5) The facility shall provide continuing education in 
the care and treatment of spinal cord injury pa- 
tients for all staff. 

(6) The facility shall provide specific staff training 
and education in the care and treatment of spinal 
cord injury. 

(7) The size of the spinal cord injury program shall be 
adequate to support a comprehensive, dedicated 
ongoing spinal cord injury program. 

Statutory Authority G.S. 13 IE- 104. 

.3032 DEEMED STATUS FOR INPATIENT 
REHABILITATION FACILITIES OR 
UNITS 

(a) If an inpatient rehabilitation facility or unit with a 
comprehensive inpatient rehabilitation program is surveyed 
and accredited by the Joint Commission for the Accredita- 
tion of Health Care Organizations (JCAHO) or the Commis- 
sion on Accreditation of Rehabilitation Facilities (CAR! 7 ), 
and has been a pproved by the Department in accordance 
with G.S. 13 IE. Article 9^ the Department deems the 
facility to be in compliance with Rules .3021 through .3031 
of this Section. 

(b) Deemed status shall be provided only if the inpatient 
rehabilitation facility or unit provides copies of survey 
reports to the Department. The JCAHO report shall show- 
that the facility or unit was surveyed for rehabilitation 
services. The CARF report shall show that the facility or 
unit was surveyed for comprehensive rehabilitation services. 
The facility or unit shall sign an agreement (Memorandum 
of Understanding) with the Department specifying these 
terms. 

£c) The inpatient rehabilitation facility or unit shall be 
subject to inspections or complaint investigations by repre- 
sentatives of the Department at any time. If the facility or 



unit is found not to be in compliance with the rules listed in 
Paragraph (a) of this Rule, the facility shall submit a plan of 
correction and be subject to a follow-up visit to ensure 
compliance. 

(d) If the inpatient rehabilitation facility or unit loses or 
does not renew its accreditation, the facility or unit shall 
notify the Department in writing within 30 days. 

Statutory Authority G.S. 13 IE- 104. 

SECTION .3100 - DESIGN AND CONSTRUCTION 

.3101 GENERAL RULES 

(a) Each facility shall be planned, constructed, equipped, 
and maintained to provide the services offered in the 
facility. 

(b) A new facility or remodeling of an existing facility 
shall meet the requirements of the North Carolina State 
Building Code, all a pplicable volumes, which is incorpo- 
rated by reference, including all subsequent amendments. 
Copies of this code may be purchased from the Department 
of Insurance Engineering Division located at 410 North 
Boylan Avenue. Raleigh. NC 27603 at a cost of two 
hundred fifty dollars ($250.00). Existing licensed facilities 
shall meet the requirements of the North Carolina State 
Building Code in effect at the time of construction or 
remodeling. 

(c) Any existing building converted from another use to 
a nursing facility shall meet all requirements of a new 
facility. 

(d) The sanitation, water su pply, sewage disposal and 
dietary facilities shall comply with the rules of the Commis- 
sion for Health Services, which are incorporated by refer- 
ence, including all subsequent amendments. Copies of these 
Rules may be obtained from the Department of Environ- 
ment, Health, and Natural Resources, Division of Environ- 
mental Health. Environmental Health Services Section, 512 
N. Salisbury Street, Raleigh, NC 27604-1148 at no cost. 

(e) The domiciliary portion of a combination facility shall 
meet the rules for a nursing facility contained in Sections 
.3100, .3200, .3300. and .3400 of this Subchapter, except 
when separated by two-hour fire-resistive construction. 
When separated by two hour fire resistive construction, the 
domiciliary portion of the facility shall meet the rules for 
domiciliary homes in H) NCAC 42D. Licensing of Homes 
for the Aged and Infirm, which are incorporated by refer- 
ence, including all subsequent amendments: and domiciliary 
resident areas must be located in the domiciliary section of 
the facility. Copies of JO NCAC 42D can be obtained free 
of charge from the Division of Facility Services, Domicili- 
ary and Group Care Section, P.O. Box 29530. Raleigh, NC 
27626-0530. 

(f) An addition to an existing facility shall meet the same 
requirements as a new facility. 

Authority G.S. 131E-104; 42 U.S.C. 1396. 

.3102 APPLICATION OF PHYSICAL PLANT 



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REQUIREMENTS 

The physical plant requirements for each facility shall be 
applied as follows: 

(1) New construction shall comply with the require- 
ments of Sections .3100-.3400 of this Subchapter. 

(2) Except where otherwise specified, existing build- 
ings shall meet licensure and code requirements in 
effect at the time of construction, alteration or 
modification. 

(3) New additions, alterations, modifications and 
repairs shall meet the technical requirements of 
Sections .3100-.3400 of this Subchapter; however, 
where strict conformance with current require- 
ments would be impractical, the authority having 
jurisdiction may a pprove alternative measures 
where the facility can demonstrate to the Divi- 
sion's satisfaction that the alternative measures do 
not reduce the safety or operating effectiveness of 
the facility. 

{4} Rules contained in Sections .3100-. 3400 of this 
Subchapter are minimum requirements and are not 
intended to prohibit buildings, systems or opera- 
tional conditions that exceed minimum require- 
ments. 

(5) Equivalency: alternate methods, procedures, 
design criteria and functional variations from the 
physical plant requirements, because of extraordi- 
nary circumstances, new programs or unusual 
conditions, may be a pproved by the authority 
having jurisdiction when the facility can effec- 
tively demonstrate to the Division's satisfaction, 
that the intent of the physical plant requirements 
are met and that the variation does not reduce the 
safety or operational effectiveness of the facility. 

(6) Where rules, codes or standards have any conflict, 
the most stringent requirement shall a pply. 

Statutory Authority G.S. 131E-104. 

.3103 SITE 

The site of the proposed facility must be a pproved by the 
Department prior to construction and shall: 
(1) be accessible by public roads and public transpor- 
tation: 
(21 be accessible to fire fighting services: 

(3) have an a pproved water su pply, sewage disposal 
system, garbage disposal system and trash disposal 
system: 

(4) meet all local ordinances and zoning laws; and 

(5) be free from exposure to hazards and pollutants. 

Statutory Authority G.S. 131E-104. 

.3104 PLANS AND SPECIFICATIONS 

(a) When construction or remodeling is planned, final 
working drawings and specifications shall be submitted by 
the owner or his a ppointed representative to the Department 



for review and approval. Schematic drawings and prelimi- 
nary working drawings shall be submitted by the owner 
prior to the required submission of final working drawings. 
The Department will forward copies of each submittal to the 
Department of Insurance and the Division of Environmental 
Health for review and approval. Three copies of the plan 
shall be provided at each submittal. 

(b") A pproval of final plans and specifications must be 
obtained from the Department prior to licensure. A pproval 
of plans shall expire after one year unless a building permit 
for the construction has been obtained prior to the expiration 
date of the a pproval of final plans. 

(c) If an a pproval expires, renewed approval shall be 
issued provided revised plans meeting all current regula- 
tions, codes, and standards are submitted and reviewed. 

(d) Completed construction or remodeling shall conform 
to the minimum standards established in Sections .3100. 
.3200. .3300. and .3400 of this Subchapter. Prior to 
a pproval for licensure, one set of "as built working draw- 
ings" shall be furnished to the Department. Final working 
drawings and building construction including building 
systems operation must be a pproved by the Department 
prior to licensure. 

(e) The owner or his designated agent shall notify the 
Department when actual construction or remodeling starts 
and at points when construction is 50 percent. 75 percent, 
and 90 percent complete and upon final completion. New 
construction or remodeling must be a pproved in writing by 
the Department prior to use. 

Statutory Authority G.S. 13 IE- 104. 

SECTION .3200 - FUNCTIONAL 
REQUIREMENTS 

.3201 REQUIRED SPACES 

(a) The net floor area of a single bedroom shall not be 
less than 100 square feet and the net floor area of a room 
for more than one bed shall not be less than 80 square feet 
per bed. The 80 square feet and 100 square feet require- 
ments shall be exclusive of closets, toilet rooms, vestibules 
or wardrobes. When a designated single room exceeds 159 
net square feet in floor area, it shall remain a single 
bedroom and cannot be used as a multi-bedroom at any 
future date. 

(b) The total space set aside for dining, recreation and 
other common use shall not be less than 25 square feet per 
bed for a nursing facility and 30 square feet per bed for the 
domiciliary portion of a combination facility. Physical 
therapy, occupational therapy and rehabilitation space shall 
not be included in this total: 

(1) In new facilities, included in the total square 
footage required by Paragraph Co) of this Rule. 
a separate dining area or areas at 10 square feet 
per bed minimum: at least one separate activity 
area at 5 square feet per bed minimum: and at 
least one separate living area at 5 square feet per 



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114 



PROPOSED RULES 



bed minimum shall be provided. 

(2) Dining, activity, and living areas shall be de- 
signed and equipp ed to provide accessibility to 
both patients confined to wheelchairs and ambu- 
latory patients. 

(3) Closets and storage units for equipment and 
su pplies shall not be included as part of the 
required dining, activity, and living floor space 
area. 

(4) Handicap accessible outdoor areas for individual 
and group activities shall be provided. 

(5) Separate bedroom closets or wardrobes shall be 
provided in each bedroom to provide each 
occupant with a minimum of 48 cubic feet of 
lockable clothing space at least half of which is 
for hanging clothes. 

(c") A toilet room shall be directly accessible from each 
patient room and from each central bathing area without 
going through the general corridor. One toilet room may 
serve two patient rooms but not more than eight beds. The 
lavatory may be omitted from the toilet room if one is 
provided in each patient room. One tub or shower shall be 
provided for each 15 beds not individually served. There 
shall be at least one bathtub accessible on three sides and 
one shower provided for each 60 beds or fraction thereof. 

(d) For each nursing unit, or fraction thereof on each 
floor, the following shall be provided: 

(1) a medication preparation area with a counter, a 
sink with four-inch faucet trim handles, a medi- 
cation refrigerator, eve level medication storage, 
cabinet storage and double locked narcotic 
storage room, located adjacent to the nursing 
station or under visual control of the nursing 
station; 

(2) a clean utility room with counter, sink with 
four-inch handles, wall and under counter stor- 
age; 

(3) a soiled utility room with counter, sink with 
four-inch handles, wall and under counter stor- 
age, a flush-rim clinical sink or water closet 
with a device for cleaning bedpans and a means 
for washing and sanitizing bedpans and other 
utensils; 

£4} a nurses' toilet and locker space for coats, 
purses, and personal belongings; 

(5) an audio-visual nurse-patient call system ar- 
ranged to ensure that a patient's call in the 
facility is noted at a staffed station; 

(6) a soiled linen storage room; 

(7) a clean linen storage room; 

(8) a nourishment station in a separate area enclosed 
with walls and doors which contains work space, 
cabinets and refrigerated storage, and a small 
stove, microwave oven or hot plate; and 

(9) one nurses' station consisting of desk space for 
writing, storage space for office su pplies, stor- 
age space for patients' records and space for 
nurses' call equipment. 



(e) Clean linen storag e shall be provided in a separate 
room from bulk supplies. Clean linen for nursing units may 
be stored in closed carts or cabinets in the clean utility room 
or in a linen closet on the unit floor. 

(f) A soiled linen room shall be provided. 

(g) Each nursing unit shall be provided with at least one 
janitor's closet. The kitchen area and laundry area each 
shall have a janitor's closet. Administration, occupational 
and physical therapy, recreation, personal care and em- 
ployee facilities shall be provided janitor's closets and may 
share one as a group. 

(h) Stretcher and wheelchair storage shall be provided. 

(i) Bulk storage shall be provided at the rate of five 
square feet of floor area per bed. 

{j} Office space shall be provided for persons holding the 
following positions: administrator, director of nursing, 
social services director, activities director and physical 
therapist. There shall also be a business office. 

0c) Each new combination facility shall provide a mini- 
mum of one residential washer and residential dryer located 
to be accessible by_ domiciliary staff, residents, and family. 

Statutory Authority G.S. 13 IE- 104. 

.3202 FURNISHINGS 

(a) Handgrips shall be provided for all toilet and bath 
facilities used by patients. Handrails shall be provided on 
both sides of all corridors used by patients. 

(b) Flame resistant privacy screens or curtains shall be 
provided in multi-bedded rooms. 

Statutory Authority G.S. 13 IE- 104. 

SECTION .3300 - FIRE AND SAFETY 
REQUIREMENTS 

.3301 NEW FACILITY REQUIREMENTS 

In addition to the requirements in Rule .3101(b) of this 
Subchapter, a new facility shall meet the following addi- 
tional requirements: 

(1) Each floor used for patient sleeping rooms shall be 
divided into at least two sections by a smoke 
partition. 

(2) Nursing units shall be designed to provide separa- 
tion from other departments or services with a 
smoke barrier. 

(3) Horizontal exits are not permitted in any new 
facility. 

Statutory Authority G.S. 13 IE- 104. 

.3302 ADDITIONS 

An addition to an existing facility shall meet the same 
requirements as a new facility except that in no case shall 
more than one horizontal exit be used to replace a required 
exit to the outside. 

Statutory Authority G.S. 131E-104. 



i 



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PROPOSED RULES 



SECTION .3400 - MECHANICAL: ELECTRICAL: 
PLUMBING 

.3401 HEATING AND AIR CONDITIONING 

Heating and cooling systems shall meet the American 
Society of Heating. Refrigeration, and Air Conditioning 
Engineers Guide rwhich is incorporated by reference, 
including all subsequent amendments: copies of this docu- 
ment may be obtained from the American Society of 
Heating. Refrigerating & Air Conditioning Engineers at 
United Engineer Center. 345 East 47th Street. New York. 
NY 10017 at a cost of one hundred nineteen dollars 
($119.00.11: and the National Fire Protection Association 
Code 90A. [current addition with all subsequent amend- 
ments which is adopted by reference; copies of this code 
may be obtained from the National Fire Protection Associa- 
tion. I Battery march Park. P.O. Box 9101. Ouincv.MA 
02269-9101 at a cost of nineteen dollars and fifty cents 
($19.50)1 with the following modifications: 

(1) Drug rooms must have positive pressure with 
relationship to adjacent areas. 

(2) Environmental temperature control systems shall 
be capable of maintaining temperatures in the 
facility at 72 degrees F. minimum in the heating 
season and a maximum of 8J. degrees j\ during 
the non-heating season. 

(3) Rooms designated for isolation shall have negative 
or positive pressure with relationship to adjacent 
areas depending upon the type of patient to be 
isolated. Exhaust for isolation rooms shall be 
ducted directly to the outdoors. 

Statutory Authority G.S. 131E-104. 

.3402 EMERGENCY ELECTRICAL SERVICE 

Emergency electrical service shall be provided for use in 
the event of failure of the normal electrical service. This 
emergency service shall consist of the following: 

(1) In any existing facility, the following shall be 
provided: 

(a) type 1 or 2 emergency lights as required by the 
North Carolina State Building Code: 

(b) additional emergency lights for all nursing 
stations, drug preparation and storage areas, and 
for the telephone switchboard, if a pplicable: 

(c) one or more portable battery-powered lamps at 
each nursing station: and 

(d) a suitable source of emergency power for 
life-sustaining equipment, if the facility admits 
or cares for occupants needing such equipment. 
to ensure continuous operation for a minimum of 
72 hours. 

(2) Any new addition to an existing facility shall meet 
the same requirements as new construction. 

(3) Any conversion of an existing building (hotel, 
motel, abandoned hospital, abandoned school, or 



other building) shall meet the same requirements 
for emergency electrical services as required for 
new construction. 

(4) For new construction, an emergency generating 
set, including the prime mover and generator, 
shall be located on the premises and shall be 
reserved exclusively for supplying the emergency 
electrical system. 

(5) Emergency electrical services shall be provided 
for new facilities as required by Rule .3101(b) of 
this Subchapter with the following modifications: 

(a) Exception No. 2 and Exception No. 3 contained 
in Section 517-10 of the North Carolina State 
Building Code. Volume IV shall not apply to 
new facilities. 

(b) Egress lighting shall be connected to the essen- 
tial electrical system at exterior of exits. 

(c) Task illumination in the switch gear and boiler 
rooms shall be connected to the essential electri- 
cal system. 

(6) The following equipment, devices, and systems 
which are essential to life, safety, and the protec- 
tion of im portant equipment or vital materials shall 
be connected to the emergency electrical system as 
follows: 

(a) nurses' calling system: 

(b) fire pump if installed: 

(c) sewerage lift or sump pumps if installed: 

(d) one elevator, where elevators are used for 
vertical transportation of patients: 

(e) equipment such as burners and pumps necessary 
for operation of one or more boilers and their 
necessary auxiliaries and controls, required for 
heating and sterilization, if installed: 

(f) equipment necessary for maintaining telephone 
service. 

(7) A minimum of one dedicated emergency branch 
circuit per bed for ventilator dependent patients is 
required in addition to the normal system recepta- 
cle at each bed location required by the North 
Carolina State Building Code. Volume IV. This 
emergency circuit shall be provided with a mini- 
mum of two duplex receptacles identified for 
emergency use. Additional emergency branch 
circuits/receptacles shall be provided where the 
electrical life support needs of the patient exceed 
the minimum requirements stated in this Para- 
graph. Each emergency circuit serving ventilator 
dependent patients shall be fed from the automati- 
cally transferred critical branch of the essential 
electrical system. This Paragraph shall apply to 
both new and existing facilities. 

(8) Heating equipment provided for ventilator depend- 
ent patient bedrooms shall be connected to the 
critical branch of the essential electrical system 
and arranged for delayed automatic or manual 
connection to the emergency power source if the 



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116 



PROPOSED RULES 



heating equipment depends upon electricity for 
proper operation. This Paragraph shall apply to 
both new and existing facilities. 
(9) Task lighting connected to the automatically 
transferred critical branch of the essential electri- 
cal system shall be provided for each ventilator 
dependent patient bedroom. This Paragraph shall 
a pply to both new and existing facilities. 

(10) Where electricity is the only source of power 
normally used for space heating, the emergency 
service shall provide for heating of patient rooms. 
Emergency heating of patient rooms will not be 
required in areas where the facility is su pplied by 
at least two separate generating sources, or a 
network distribution system with the facility 
feeders so routed, connected, and protected that a 
fault any place between the generators and the 
facility will not likely cause an interruption. 

(1 1) The emergency electrical system shall be so 
controlled that after interruption of the normal 
electric power su pply, the generator is brought to 
full voltage and frequency and connected with 10 
seconds through one or more primary automatic 
transfer switches to all emergency lighting, 
alarms, nurses' call, and equipment necessary for 
maintaining telephone service. All other lighting 
and equipment required to be connected to the 
emergency system shall either be connected 
through the 10 second primary automatic transfer 
switching or shall be subsequently connected 
through other automatic or manual transfer switch- 
ing. Receptacles connected to the emergency 
system shall be distinctively marked for identifica- 
tion. 

(12) Sufficient fuel shall be stored for the operation of 
the emergency generator for a period not less than 
72 hours, on a 24-hour per day operational basis. 
The generator system shall be tested and main- 
tained per National Fire Protection Association 
(NFPA) code 99. current addition with all subse- 
quent amendments, which is adopted by reference. 
Copies of this code may be obtained from the 
National Fire Protection Association. I 
Batterymarch Park. P.O. Box 9101. Quincy. MA 
02269-9101 at a cost of thirty one dollars 
($31.00). Records of running time shall be 
maintained and kept available for reference. 

(13) Existing facilities shall have electrical systems that 
comply with licensure standards in effect at the 
time a license is first issued. Any remodeling that 
results in changes in service delivery shall comply 
with current licensure requirements to su pport the 
delivery of those services. 

Statutory Authority G.S. 13 IE- 104. 

.3403 GENERAL ELECTRICAL 

(a) All main water supply shut off valves in the sprinkler 



system shall be electronically supervised so that if any valve 
is closed an alarm will sound at a continuously manned 
central station. 

(b) No two adjacent emergency lighting fixtures shall be 
on the same circuit. 

(c) Receptacles in bathrooms shall have ground fault 
protection. 

(d) For new construction, and remodeling of spaces to be 
used as patient rooms that involve modification of the 
electrical system in patient rooms, each patient bed location 
shall be provided with a minimum of four single or two 
duplex receptacles. Two sin gle receptacles or one duplex 
receptacle shall be connected to the critical branch of the 
emergency power system at each bed location. Each patient 
bed location shall also be provided with a minimum of two 
single receptacles or one duplex receptacle connected to the 
normal electrical system. 

(e) Each patient bed location shall be su pplied by at least 
two branch circuits. 

(f) The fire alarm system shall be installed to transmit an 
alarm automatically to the fire department that is legally 
committed to serve the area in which the facility is located, 
by the most direct and reliable method a pproved by local 
ordinances. 

(g) In patient areas, fire alarms shall be gongs or chimes 
rather than horns or bells. 

(h) All receptacles in patient use areas must be grounded 
by an insulated conductor sized in accordance with Table 
250-95 of the North Carolina State Building Code. Volume 

DL 

Statutory Authority G.S. 131E-104. 

.3404 OTHER 

(a) In general patient areas, each room shall be served by 
at least one calling station and each bed shall be provided 
with a call button. Two call buttons serving adjacent beds 
may be served by one calling station. Calls shall register 
with the floor staff and shall activate a visible signal in the 
corridor at the patient's or resident's door. In 
multi-corridor nursing units, additional visible signals shall 
be installed at corridor intersections. In rooms containing 
two or more calling stations, indicating lights shall be 
provided at each station. Nurses' calling systems which 
provide two-way voice communication shall be equipp ed 
with an indicating light at each calling station which lights 
and remains Ugh ted as long as the voice circuit is operating. 
A nurses' call emergency button shall be provided for 
patients' and residents' use at each patient and resident 
toilet, bath, and shower. 



(b) At least one telephone shall be available in each area 
to which patients are admitted and additional telephones or 
extensions as are necessary to ensure availability in case of 
need. 

(c) General outdoor lighting shall be provided adequate to 
illuminate walkways and drive. 

(d) A flow of hot water shall be within safety ranges 
specified as follows: 



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PROPOSED RULES 



Patient Areas ; 6 172 gallons per hour per bed and 
at a temperature of 100 -116 degrees F; and 

Dietary Services : 4 gallons per hour per bed and 
at a minimum temperature of 140 degrees Fi and 

Laundry Area z 4 J_/2 gallons per hour per bed and 
at a minimum temperature of 140 degrees F. 

(e) Plumbing systems shall meet the requirements of the 
North Carolina State Building Code, Volume U. 

(f) Medical gas and vacuum systems shall be installed, 
tested, and maintained in accordance with the National Fire 
Protection Code 99 current addition with all subsequent 
amendments, which is adopted by reference. Copies of this 
code may be obtained from the National Fire Protection 
Association, 1 Battery march Park. P.O. Box 9101. 
Ouincy.MA 02269-9101 at a cost of thirty one dollars 
($3 1.00). 

(g) The Administrator shall assure that isolation facilities 
as approved by the Department are available and used for 
any patient admitted or retained with a communicable 
disease. 

(h) Each facility shall have a wanderer control system to 
aid staff in the supervision of patients who wander or are 
disoriented. 

Statutory Authority G.S. 131E-104. 

Notice is hereby given in accordance with G.S. 
150B-21.2 that the Director of the Division Of Mental 
Health, Developmental Disabilities and Substance Abuse 
Services intends to amend rule cited as 10 NCAC 18J . 0803. 

Proposed Effective Date: July 1, 1995. 



OTHER PROGRAMS 

SUBCHAPTER 18J - AREA PROGRAM 
MANAGEMENT STANDARDS 

SECTION .0800 - ESTABLISHMENT OF AN 
AREA AUTHORITY APPEALS PANEL 

.0803 APPEALS PROCEDURES 

(a) Appeals of the decision of local area authorities shall 
be forwarded, along with all supplementary documentation 
considered during the local area appeals process, to the 
Division Director within 44 15 days of the local decision 
being rendered. 

(b) The Division Director shall forward all information to 
the Chair of the Panel within five working days. 

(c) The Panel shall complete an administrative review and 
notify the appealing party and the area program of its 
decision, in writing, within +4 J_5 days of receipt of the 
appeal. Unless further appealed within 44 15 days of the 
date of this decision, this decision shall be considered final. 

(d) Either party named in the appeal may request a 
hearing by the Panel before the Panel's administrative 
decision is considered to be final, by submitting a written 
request to the Chair of the Panel, within 44 15 days of the 
date of the administrative review decision. 

(e) A hearing shall be scheduled by the Panel no more 
than 30 days after a written request for a hearing is received 
by the Chair. 

(f) The hearing shall be scheduled at a time and place 
designated by the Chair. 

(g) The appealing party and the area program shall be 
notified of the time and place of the hearing no less than 44 
15 days prior to the hearing. 



A Public Hearing will be conducted at 10:00 a.m. on May 
17, 1995 at the Division ofMH/DD/SAS, Albemarle Bldg. , 
325 N. Salisbury St., Room 1112, Raleigh, NC 27603. 



Statutory Authority G.S. 122C-1 12(a); 122C-151.4. 



*«•«•••*****«***«* 



Reason for Proposed Action: To provide area programs 
with a time frame that is consistent in the Appeals Proce- 
dures for the Division and for Carolina Alternatives. 

Comment Procedures: Any interested person may present 
comments by oral presentation or submitting a written 
statement. Persons wishing to make oral presentations 
should contact Charlotte Tucker, Division ofMH/DD/SAS, 
325 N. Salisbury St. , Raleigh, NC 27603, 919-733-4774. 
Comments submitted as a written statement must be sent to 
the above address no later than May 17, 1995, and must 
state the rule to which the comments are addressed. Time 
limits for oral remarks may be imposed. 

Fiscal Note: This Rule does not affect the expenditures or 
revenues of local government or state funds. 

CHAPTER 18 - MENTAL HEALTH: 



Notice is hereby given in accordance with G.S. 
150B-21.2 that the DHR/Division of Medical Assistance 
intends to amend rules cited as 10 NCAC 26B .0124 and 
26H .0213. 

Proposed Effective Date: July 1, 1995. 

A Public Hearing will be conducted at 1:30 p.m. on May 
17, 1995 at the North Carolina Division of Medical Assis- 
tance, 1985 Umstead Drive, Room 132, Raleigh, NC. 

Reason for Proposed Action: 

10 NCAC 26B .0124 - Some parts of the state, particularly 
the rural areas, have a shortage of qualified supervisors for 
HIV case management services. Allowing graduates of 
accredited schools of professional nursing to become 
qualified HIV case management supervisors will increase the 
access of services throughout the state. 



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118 



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10 NCAC 26H .0213 - To amend the North Carolina 
Hospital Inpatient Reimbursement Plan effective January 1 , 
1995 to establish a disproportionate share pool for those 
hospitals that qualify as disproportionate share hospital and 
also operate a Medicare approved graduate medical educa- 
tion program. 

Comment Procedures: Written comments concerning this 
rule-making action must be submitted by May 17, 1995 to: 
Division of Medical Assistance, 1985 Umstead Drive, 
Raleigh, NC 27603, ATTN: Portia Rochelle, APA Coordina- 
tor. Oral comments may be presented at the hearing. In 
addition, a fiscal note is available upon written request from 
the same address. 

Fiscal Note: 10 NCAC 26H .0124 affects the expenditure 
or distribution of State funds subject to the Executive Budget 
Act, Article 1 of Chapter 143. 10 NCAC 26H . 0213 does 
not have a fiscal impact. 

CHAPTER 26 - MEDICAL ASSISTANCE 

SUBCHAPTER 26B - MEDICAL ASSISTANCE 
PROVIDED 

SECTION .0100 - GENERAL 

.0124 HTV CASE MANAGEMENT 

(a) The components of HIV case management are listed 
below. In order to be reimbursed by the Division of 
Medical Assistance, a provider shall provide all of these 
components: 

(1) Evaluation of the client's situation to determine 
the need for initial case management services; 

(2) Comprehensive assessment of the client's health 
care, psychosocial, environmental and financial 
needs; 

(3) Development and implementation of a plan of 
care which includes goals, services to be pro- 
vided and progress notes; 

(4) Coordination of service delivery when multiple 
providers or programs are involved in care 
provision; 

(5) Monitoring to ensure that services received meet 
the client's needs and are consistent with good 
quality of care; 

(6) Follow-up an assessment to determine the con- 
tinued appropriateness of services, the correct 
level of care, and the continued need for ser- 
vices; 

(7) Discharge of the client from service; and 

(8) Locating and helping access available systems, 
resources and services within the community to 
meet the client's needs. 

(b) Persons are eligible to receive HIV case management 
services if they: 

(1) Have a medical diagnosis of HTV disease or HIV 
seropositivity; and 



(2) Are eligible for regular Medicaid services; and 

(3) Are not institutionalized; and 

(4) Are not recipients of other Medicaid-reimbursed 
case management services provided through the 
State's home and community-based waivers or 
the State Plan. 

(c) Provider Qualifications. Providers of HIV case 
management services shall: 

(1) Be enrolled in accordance with section 
1902(a)(23) of the Social Security Act; and 

(2) Meet applicable State and Federal Laws govern- 
ing the participation of providers in the Medicaid 
program; and 

(3) Be certified by the AIDS Care Branch, Division 
of Adult Health Promotion, Department of 
Environment, Health and Natural Resources as 
a qualified HTV case management provider. To 
be certified, a provider must: 

(A) Submit an application to the AIDS Care 
Branch that includes the provider's plans for : 

(i) Provision of all the HIV case management 
components in 10 NCAC 26B .0124(a); 
and 

(ii) Quality assurance, including the monitor- 
ing and evaluation of case management 
records. 

(B) Have qualified case managers with supervision 
provided by a supervisor who meets the re- 
quirements in 10 NCAC 26 B .0124(d), except 
that case managers qualified under 10 NCAC 
26B .0124(e)(4) shall have all their charts 
reviewed and signed by such a supervisor. 

(d) Supervisor Qualification. An HIV case management 
supervisor shall meet the following qualifications: 

(1) Have a master's level degree in a human service 
area including, but not limited to, Social Work, 
Sociology, Child Development, Maternal and 
Child Health, Counseling, Psychology or Nurs- 
ing and one year of experience in case manage- 
ment; or 

(2) Have a bachelor's degree in a human service 
including, but not limited to, Social Work, 
Sociology, Child Development, Maternal and 
Child Health, Counseling, Psychology or Nurs- 
ing and two years experience in case manage 
m e nt. management: or 

(3) Have graduated from an accredited school of 
professional nursing and completed three years 
of professional nursing experience, including 
two years in Public Health. Be licensed to 
practice as a registered nurse and have a mini- 
mum of two years experience in case manage- 
ment; or 

(4) Have graduated from an accredited school of 
professional nursing and completed three years 
of professional nursing experience, including 
two years experience supervising nurses respon- 
sible for developing and maintaining care plans 



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» 



I 



I 



and coordinating care and services for patients 
receiving care in their homes. Be licensed to 
practice as a registered nurse and have a mini- 
mum of two years experience in case manage- 
ment. 
(e) Case Manager Qualifications. HIV case managers 
shall meet the following qualifications: 

(1) Have a master's degree in a human service area 
including, but not limited to, Social Work, 
Sociology, Child Development, Maternal and 
Child Health, Counseling, Psychology or Nurs- 
ing; or 

(2) Have a bachelor's level degree in a human 
service area including, but not limited to, Social 
Work, Sociology, Child Development, Maternal 
and Child Health, Counseling, Psychology or 
Nursing and two years experience working in 
human services; or 

(3) Be a licensed Registered Nurse, Nurse Practitio- 
ner, Physician Assistant or Certified Substance 
Abuse Counselor with two years experience 
working in human o e rvio e o. services; or 

(4) Have a high school diploma and two years 
experience providing HIV case management. A 
person who qualifies under 10 NCAC 26B .0124 
(e)(4) may serve as an HIV case manager for 
five years from date of employment as an HIV 
case manager in an agency certified to provide 
HIV case management. If an agency is not a 
certified HIV case management provider at the 
time of the person's employment as an HIV case 
manager, the five year time period begins with 
the agency's certification date. After the five 
year period ends, the person must meet HIV 
case manager requirements defined in 10 NCAC 
26B .0124 (c)(l),(2), or (3) in order to continue 
to providing HIV case management services 
services; or 

(5) HTV case manages shall attend, at least annually, 
training sessions approved by the AIDS Care 
Branch, Division of Adult Health Promotion, 
Department of Environment, Health and Natural 
Resources. 

Authority G.S. 108A-25(b); 108A-54; 42 C.F.R. 440.169; 
Social Security Act 1915(b). 

SUBCHAPTER 26H - REIMBURSEMENT 
PLANS 

SECTION ,0200 - HOSPITAL INPATIENT 
REIMBURSEMENT PLAN 

.0213 DISPROPORTIONATE SHARE HOSPITALS 

(a) Hospitals that serve a disproportionate share of low- 
income patients and have a Medicaid inpatient utilization 
rate of not less than one percent are eligible to receive rate 



adjustments. The cost report data and financial information 
that is required in order to qualify as a disproportionate 
share hospital effective April 1, 1991 is based on the fiscal 
year ending in 1989 for each hospital, as submitted to the 
Division of Medical Assistance on or before April 1, 1991. 
The cost report data and financial information to qualify as 
a disproportionate share hospital effective July 1, 1991 is 
based on the fiscal year ending in 1990 for each hospital, as 
submitted to the Division of Medical Assistance on or 
before September 1, 1991. In subsequent years, qualifica- 
tions effective July 1 of any particular year are based on 
each hospital's fiscal year ending in the preceding calendar 
year. The patient days, costs, revenues, or charges related 
to nursing facility services, swing-bed services, home health 
services, outpatient services, or any other service that is not 
a hospital inpatient service cannot be used to qualify for 
disproportionate share status. A hospital is deemed to be a 
disproportionate share hospital if: 

(1) The hospital has at least two obstetricians with 
staff privileges at the hospital who have agreed 
to provide obstetric services to individuals 
eligible for Medicaid. In the case of a hospital 
located in a rural area, the term obstetrician 
includes any physician with staff privileges at 
the hospital to perform non-emergency obstetric 
services as of December 21, 1987 or to a hospi- 
tal that predominantly serves individuals under 
18 years of age; and 

(2) The hospital's Medicaid inpatient utilization rate, 
defined as the percentage resulting from dividing 
Medicaid patient days by total patient days, is at 
least one standard deviation above the mean 
Medicaid inpatient utilization rate for all hospi- 
tals that receive Medicaid payments in the state; 
or 

(3) The hospital's low income utilization rate ex- 
ceeds 25 percent. The low-income utilization 
rate is the sum of: 

(A) The ratio of the sum of Medicaid inpatient 
revenues plus cash subsidies received from the 
State and local governments, divided by the 
hospital's total patient revenues; and 

(B) The ratio of the hospital's gross inpatient 
charges for charity care less the cash subsidies 
for inpatient care received from the State and 
local governments divided by the hospital's 
total inpatient charges; or 

(4) The sum of the hospital's Medicaid revenues, 
bad debts allowance net of recoveries, and 
charity care exceeds 20 percent of gross patient 
revenues; or 

(5) The hospital, in ranking of hospitals in the State, 
from most to least in number of Medicaid 
patient days provided, is among the top group 
that accounts for 50% of the total Medicaid 
patient days provided by all hospitals in the 
State; or 



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120 



PROPOSED RULES 



(6) Psychiatric Hospitals operated by the North 
Carolina Department of Human Resources, 
Division of Mental Health, Developmental 
Disabilities, Substance Abuse Services 
(DMH/DD/SAS) and UNC Hospitals operated 
by the University of North Carolina. 

(b) The rate adjustment for a disproportionate share 
hospital is 2.5 percent plus one fourth of one percent for 
each percentage point that a hospital's Medicaid inpatient 
utilization rate exceeds one standard deviation of the mean 
Medicaid inpatient utilization rate in the State. The rate 
adjustment is applied to a hospital's payment rate exclusive 
of any previous disproportionate share adjustments. 

(c) Effective July 1, 1994, hospitals eligible under 
Subparagraph (a)(6) of this Rule will be eligible for dispro- 
portionate share payments, in addition to other payments 
made under the North Carolina Medicaid Hospital reim- 
bursement methodology, from a disproportionate share pool 
under the circumstances specified b e low: in Subparagraphs 
(1), (2) and (3) of this Paragraph. 

(1) An eligible hospital will receive a monthly 
disproportionate share payment based on the 
monthly bed days of services to low income 
persons of each hospital divided by the total 
monthly bed days of services to low income 
persons of all hospitals items allocated funds. 

(2) This payment shall be in addition to the dispro- 
portionate share payments made in accordance 
with Subparagraphs (a)(1) through (5) of this 
Rule. However, DMH/DD/SAS operated 
hospitals are not required to qualify under the 
requirements of Subparagraphs (a)(1) through 
(5) of this Rule. 

(3) The amount of allocated funds shall be deter- 
mined by the Director of the Division of Medi- 
cal Assistance, but not to exceed the quarterly 
grant award of funds (plus appropriate non- 
federal match) earmarked for disproportionate 
share hospital payments less payments made 
under Subparagraphs (a)(1) through (5) divided 
by three. 

In Subparagraph (c)(1) of this Rule, bed days of services 
to low income persons is defined as the number of bed days 
provided to individuals that have been determined by the 
hospital as patients that do not possess the financial re- 
sources to pay portions or all charges associated with care 
provided. 

Low income persons include those persons that have been 
determined eligible for medical assistance. The count of 
bed days used to determine payment is based upon the 
month immediately prior to the month that payments are 
made. 

Disproportionate share payments to hospitals are limited 
in accordance with The Social Security Act as amended, 
Title XIX section 1923 (g), limit on amount of payment to 
hospitals. 

(d) Effective January L. 1995 and subject to the availabil- 
ity of funds, hospitals that qualify as disproportionate share 



hospitals under Subparagraphs (aid) through (5) of this 
Rule and that also operate Medicare a pproved graduate 
medical education programs will be eligible for dispropor- 
tionate share payments for hospital inpatient services in 
addition to other payments made under the North Carolina 
Medicaid Hospital DRG reimbursement methodology from 
a disproportionate share pool under the circumstances 
specified in Subparagraphs (1) and (2) of this Paragraph: 

(1) Qualifications effective January 1, 1995 through 
September 30. 1995 are based on cost report 
data and financial information for the fiscal year 
ending in 1993 as submitted to the Division of 
Medical Assistance on or before September l± 
1994. Qualifications for the 12 month period 
beginning October 1^ 1995 and subsequent 12 
month periods beginning October I of each year, 
will be based on cost report data and financial 
information for the fiscal year ending in the 
preceding calendar year, as submitted to the 
Division of Medical Assistance on or before 
September 1 immediately preceding the 12 
month period beginning October 1 for which 
eligibility is being determined. 

(2) Additional payments for the period from January 
L. 1995 throug h September 30. 1995 will be 
made based on hospital cost per case mix index 
adjusted discharge, as established by Exhibit 5.1 
contained in the report entitled "DRG-Based 
Prospective Payment Methodology for Inpatient 
Services" dated January 25. 1995 prepared by 
Myers and Stauffer. Chartered Certified Public 
Accountants, for the North Carolina Division of 
Medical Assistance and arranged from low to 
high as specified in Parts (A) and (B) of this 
Subparagraph: 

(A) Hospitals with a calculated cost per case mix 
index adjusted discharge cost of three thousand 
one hundred fifty six dollars ($3.156) or less 
will be entitled to an additional payment in an 
amount that when added to other Medicaid 
payments may not exceed 100% of allowable 
Medicaid costs, as determined by the Medicare 
principles of cost reimbursement; 

(B) Hospitals with a calculated cost per case mix 
index adjusted discharge cost of more than 
three thousand one hundred fifty six dollars 
($3.156) will be entitled to additional payments 
in an amount that when added to other Medic- 
aid payments may not exceed 85% of allow- 
able Medicaid costs, as determined by Medi- 
care principles of cost reimbursement. 

(3) Additional payments for the 12 month period 
beginning October J^ 1995 and for each subse- 
quent 12 month period will be determined as 
specified in Parts (A). (B) and (C) of this Sub- 
paragraph: 

(A) The calculated cost per case mix index ad- 
justed discharge amount of three thousand one 



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April 17, 1995 



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PROPOSED RULES 



> 



hundred fifty six ($3.156) shall be updated 
annually by the National Hospital Market 
Basket Index and the most recent actual and 
projected cost data available from the North 
Carolina Office of State Budget and Manage- 
ment; 

(B) Each hospital's cost per case mix index ad- 
justed discharge will be ascertained by analysis 
of charges for Medicaid inpatient claims reim- 
bursed under the DRG methodology and paid 
during the immediately preceding calendar 
year, multiplied by each hospital's ratio of cost 
to charges derived from cost report data and 
financial information for the fiscal year of each 
hospital ending in the preceding calendar year, 
as submitted to the Division of Medical Assis- 
tance on or before the first day of September 
immediately preceding the 12 month period 
beginning October 1. for which eligibility is 
being determined; and 

(C) Hospitals with a case mix index adjusted 
discharge cost equal to or less than three 
thousand one hundred fifty six ($3.156) plus 
any annual updated amount will be entitled to 
an additional payment in an amount that when 
added to other Medicaid payments may not 
exceed 100% of allowable Medicaid costs, as 
determined by the Medicare principles of cost 
reimbursement; hospitals with calculated costs 
per case mix index adjusted discharge greater 
than three thousand one hundred fifty six 
($3.156) plus any annual updated amount will 
be entitled to additional payments in an amount 
that when added to other Medicaid payment 
does not exceed 85% of allowable Medicaid 
costs, as determined by Medicare principles of 
cost reimbursement. 

(4) Payments will be made on an estimated basis no 
less frequently than quarterly during the period 
for which such payments are to be made- 
Estimated payments will be based on costs 
incurred and payments received for Medicaid 
inpatient DRG services during the most recent 
fiscal year for which the Division of Medical 
Assistance has a completed cost report. Esti- 
mated payments made to each hospital will be 
cost settled as determined by an independent 
CPA furnished by the provider, based on cost 
reports for the period for which payments are 
made, and appropriate adjustments will be made 
to assure that such payments do not exceed the 
hospital's net cost of providing services to 
Medicaid patients. 

(5) Payments may not exceed the amount of funds 
available as determined by the Director of the 
Division of Medical Assistance. Should avail- 
able funds be insufficient to pay_ in full the 



(61 



authorized payments, the Division of Medical 
Assistance shall ascertain maximum payments 
allowable and the funds available to qualifying 
hospitals shall be prorated on that basis. 
The changes to disproportionate share payments 
authorized by this Paragraph are in accordance 
with G.S. 108A-55(c). 



Authority G.S. 108A-25(b); 108A-54; 108A-55; 42 C.F.R. 
447, Subpart C. 



TITLE 12 - DEPARTMENT OF 
JUSTICE 

Notice is hereby given in accordance with G.S. 
150B-21.2 that the North Carolina Criminal Justice 
Education and Training Standards Commission intends to 
amend rules cited as 12 NCAC 9A .0204; 9B .0113, .0201 - 
.0202, .0205 - .0206, .0210, .0212 - .0214, .0226 - .0228, 
.0232 -.0233; 9C .0401, .0601; 9D .0102, .0104 - .0106. 

Proposed Effective Date: August 1, 1995. 

A Public Hearing will be conducted at 9:00 a.m. on June 
1, 1995 at the Hearing Room of the Alcoholic Beverage 
Control Commission Building, 3322 Garner Road, Raleigh, 
NC. 

Reason for Proposed Action: The Standards Commission 
has authorized rule-making authority to propose amending 
several of its administrative rules in order to better define 
the minimum standards that regulate the criminal justice 
officer profession as well as the criminal justice training 
schools. Additionally, the Commission is updating several 
incorrect rule references to G. S. 150B and is adding eight 
new types of radar instruments to the approved list. 

Comment Procedures: Any person interested in these rules 
may present oral or written comments relevant to the 
proposed action at the Public Rule-Making Hearing. In 
addition, the record of hearing will be open for receipt of 
written comments from April 17, 1995 to June 1, 1995. 
Written comments not presented at the hearing should be 
directed to David D. Cashwell, Criminal Justice Standards, 
P. O. Box 149, Raleigh, NC 27602. The proposed rules are 
available for public inspection and copies may be obtained 
at the following address: Criminal Justice Standards, P.O. 
Box 149, Raleigh, NC 27602 (Room 150, Court of Appeals 
Building, 1 West Morgan St. , Raleigh, NC). 

Fiscal Note: These Rules do not affect the expenditures or 
revenues of local government or state funds. 

CHAPTER 9 - CRIMINAL JUSTICE 
EDUCATION AND TRAINING STANDARDS 



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PROPOSED RULES 



SUBCHAPTER 9A - CRIMINAL JUSTICE 

EDUCATION AND TRAINING STANDARDS 

COMMISSION 

SECTION .0200 - ENFORCEMENT OF RULES 

.0204 SUSPENSION: REVOCATION: 

OR DENIAL OF CERTIFICATION 

(a) The Commission shall revoke the certification of a 
criminal justice officer when the Commission finds that the 
officer has committed or been convicted of: 

(1) a felony offense; or 

(2) a criminal offense for which the authorized 
punishment included imprisonment for more than 
two years. 

(b) The Commission may suspend, revoke, or deny the 
certification of a criminal justice officer when the Commis- 
sion finds that the applicant for certification or the certified 
officer: 

(1) has not enrolled in and satisfactorily completed 
the required basic training course in its entirety 
within prescribed time periods relevant or appli- 
cable to a specified position or job title; 

(2) fails to meet or maintain one or more of the 
minimum employment standards required by 12 
NCAC 9B .0100 for the category of the officer's 
certification or fails to meet or maintain one or 
more of the minimum training standards re- 
quired by 12 NCAC 9B .0200 or 12 NCAC 9B 
.0400 for the category of the officer's certifica- 
tion; 

(3) has committed or been convicted of: 

(A) a criminal offense or unlawful act defined in 
12 NCAC 9A .0103 as a Class B misde- 
meanor; or 

(B) four or more criminal offenses or unlawful 
acts defined in 12 NCAC 9A .0103 as a Class 
A misdemeanor, each of which occurred after 
the date of initial certification; 

(4) has been discharged by a criminal justice agency 
for commission or conviction of: 

(A) a motor vehicle offense requiring the revoca- 
tion of the officer's driver's license; or 

(B) any other offense involving moral turpitude; 

(5) has been discharged by a criminal justice agency 
because the officer lacks the mental or physical 
capabilities to properly fulfill the responsibilities 
of a criminal justice officer; 

(6) has knowingly made a material misrepresentation 
of any information required for certification or 
accreditation; 

(7) has knowingly and willfully, by any means of 
false pretense, deception, defraudation, misrep- 
resentation or cheating whatsoever, obtained or 
attempted to obtain credit, training or certifica- 
tion from the Commission; 

(8) has knowingly and willfully, by an means of 
false pretense, deception, defraudation, misrep- 



(9) 



(10) 



(11) 



(12) 



(13) 



(14) 



resentation or cheating whatsoever, aided an- 
other person in obtaining or attempting to obtain 
credit, training or certification from the Com- 
mission; 

has failed to make either of the notifications as 
required by 12 NCAC 9B .0101(7); 
has been removed from office by decree of the 
Superior Court in accord with the provisions of 
G.S. 128-16 or has been removed from office by 
sentence of the court in accord with the provi- 
sions of G.S. 14-230; 

fails to satisfactorily complete the minimum 
in-service training requirements as prescribed in 
12 NCAC 9E; 

has refused to submit to an applicant or lateral 
transferee drug screen as required by these 
Rules; ef 

has produced a positive result on a drug screen 
reported to the Commission as specified in 12 
NCAC 9C .0310, where the positive result 
cannot be explained to the Commission's satis 
faction, satisfaction; or 



♦ 



has been denied certification or had such justice 

officer certification suspended or revoked by the 

North Carolina Sheriffs' Education and Training 

Standards Commission. 

(c) Following suspension, revocation, or denial of the 

person's certification, the person may not remain employed 

or appointed as a criminal justice officer and the person may 

not exercise any authority of a criminal justice officer 

during a period for which the person's certification is 

suspended, revoked, or denied. 

Statutory Authority G.S. 17C-6; 17C-10. 

SUBCHAPTER 9B - STANDARDS FOR 

CRIMINAL JUSTICE EMPLOYMENT: 

EDUCATION: AND TRAINING 

SECTION .0100 - MINIMUM STANDARDS 
FOR CRIMINAL JUSTICE EMPLOYMENT 

.0113 MINIMUM STANDARDS PROBATION/ 
PAROLE OFFICERS-SURVEDLLANCE 

In addition to the requirements for criminal justice officers 
contained in Rule .0101 of this Section, every proba- 
tion/parole officer-surveillance shall hav e attain e d — the 
associate dogroo or have satisfactorily completed at least 60 
semester hours of educational credit or 90 quarter hours of 
e duoational — orodit at an aoor e ditod — t e chnical — institut e , 
t e ohnioal — ooll e g e , — community — coll e g e , — junior coll e g e , 
collogo, or university, be a high school graduate or have 
passed the General Educational Development Test indicating 
high school equivalency. 

Statutory Authority G.S. 17C-6. 

SECTION .0200 - MINIMUM STANDARDS 



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PROPOSED RULES 



FOR CRIMINAL JUSTICE SCHOOLS AND 

CRIMINAL JUSTICE TRAINING PROGRAMS 

OR COURSES OF INSTRUCTION 

.0201 ADMINISTRATION OF CRIMINAL 
JUSTICE SCHOOLS 

(a) The executive officer or officers of the institution or 
agency sponsoring any criminal justice training program or 
course of instruction shall have primary responsibility for 
implementation of these Rules and standards and for 
administration of the school. The executive officer or 
officers of the institution or agency shall secure School 
Accreditation pursuant to 12 NCAC 9C .0401 prior to 
offering any criminal justice training course. 

(b) The executive officers shall designate not more than 
one compensated staff member for each 
commission-accredited program for which the institution or 
agency has been granted accreditation. Such staff member 
shall be formally certified by the Commission under Section 
.0500 of this Subchapter to be the criminal justice school 
director. The school director shall have administrative 
responsibility for planning, scheduling, presenting, coordi- 
nating, reporting, and generally managing each sponsored 
accredited criminal justice training course. If the accredited 
institution or agency assigns additional responsibilities to the 
certified school director during the planning, development, 
and implementation of an accredited basic recruit training 
course, an additional qualified staff person must be desig- 
nated to assist the school director in the administration of 
the course. This person must be selected by the school 
director and must attend a course orientation conducted by 
Standards Division staff and attend the annual School 
Directors' Conference. 

(c) The executive officers shall permanently maintain 
records of all criminal justice training courses sponsored or 
delivered by the school, reflecting: 

(1) course title; 

(2) delivery hours of course; 

(3) course delivery dates; 

(4) names and addresses of instructors utilized 
within designated subject-matter areas; and 

(5) a roster of enrolled trainees, showing class 
attendance and designating whether each 
trainee's course participation was successful or 
unsuccessful; 

(6) copies of all rules, regulations and guidelines 
developed by the school director; 

(7) documentation of any changes in the initial 
course outline, including substitution of instruc- 
tors; and 

(8) documentation of make-up work achieved by 
each individual trainee, including test scores and 
methods. 

(d) The executive officers of the institution or agency 
sponsoring any criminal justice training program or course 
of instruction shall meet or exceed the following specifica- 
tions: 



(1) acquire and allocate sufficient financial resources 
to provide commission certified instructors and 
to meet other necessary program expenses; 

(2) provide adequate secretarial, one designated 
clerical , and other supportive staff aoaiatanoo as 
required by th e oohool dir e ctor su pport person to 
assist the school director in maintaining required 
records, complete reports, and provide other 
clerical needs as required by the school director; 

(3) provide or make available suitable facilities, 
equipment, materials, and supplies for compre- 
hensive and qualitative course delivery, specifi- 
cally including the following: 

(A) a comfortable, well-lighted and ventilated 
classroom with a seating capacity sufficient to 
accommodate all attending trainees;- specifi- 
cally: 

(i) provide a minimum of 24 square feet of 

floor space per trainee; 
(ii) provide over-head lighting measuring at a 

minimum. 70 foot candles at desk level; 
(iii) provide an adult size table and chair for 
each trainee; 

(B) audio-visual equipment and other instructional 
devices and aids necessary and beneficial to 
the delivery of effective training; 

(C) a library for trainees' use covering the sub- 
ject-matter areas relevant to the training 
course, maintained in current status and having 
sufficient copies for convenient trainee access; 

(D) wh e r e r e quir e d by cours e content, provid e or 
make — available — facilitie s , — equipment, — aad 
supplie s to provide training in physical and 
motor skill exorcis e s suoh as d e f e noiv e taotioo, 
fir e arms qualification, and purouit/dofonoivo 
driving, a firearms firing range designed for 
criminal justice firearms instruction to conduct 
the basic recruit firearms course, with the 
following specifications: 

(i) an operational public address system of 
sufficient volume to be audible to persons 
wearing ear plugs or other hearing protec- 
tion while firearms are being discharged: 

(ii) an emergency first-aid kit: 

(iii) access limited to criminal justice trainees, 
criminal justice instructors, and personnel 
authorized by the school director when 
firearms are being discharged; 

(iv) warning signs posted at all access points 
which clearly identify the area as a crimi- 
nal justice firing range; 

(v) restrooms. drinking water and a rain-resis- 
tant shelter for personnel engaged jb train- 
ing; and 

(vi) telephone or radio communications imme- 
diately available to range instructors; 

(E) a driving range designated for criminal justice 



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April 17, 1995 



124 



PROPOSED RULES 



training, adequate in size and design to safely 
conduct the law enforcement basic recruit 
driving course, with the following specifica- 
tions: 
(i) secured by barriers from through traffic 
while training is being conducted on the 
range; 
(ii) warning signs posted at all vehicle access 
points that shall clearly identify the area as 
a law enforcement training driving range 
and limit access to criminal justice train- 
ees, criminal justice instructors, and per- 
sonnel authorized by the school director; 
(iii) an emergency first-aid kit; 
(iv) access to at least two automobiles designed 
and equipped for criminal justice driver 
training; 
(v) restrooms and drinking water for person- 
nel engaged in training; and 
(vi) telephone or radio communications imme- 
diately available to range instructors; 

(F) a suitable area designated for criminal justice 
defensive tactics instruction which enables the 
safe execution of the basic recruit defensive 
tactics course, with the following specifica- 
tions: 

(i) permanent or portable cushioned floor 

matting; 
(ii) an emergency first-aid kit: and 
(iii) telephone or radio communications imme- 
diately available to defensive tactics in- 
structors; 

(G) a suitable area for the conducting of physical 
fitness training, with the following specifica- 
tions: 

(i) an obstacle course designed and con- 
structed according to specifications out- 
lined in the Basic Law Enforcement Train- 
ing Course Management Guide; 
(ii) a ppropriate space for running, weight 

training, calisthenics; and aerobics; 
(iii) restrooms and drinking water for person- 
nel engaged in training; 
(iv) shower facilities, if physical fitness train- 
ing is conducted prior to classroom train- 
ing. 
(e) Th e sponsoring institution, unless it i s an ag e noy or 
department aocroditod by the Commiaoion to provide basic 
training to its own per s onnel, is not required to assumo the 
oosts of providing the following sp e oifi e d e quipm e nt and 
supplies for train ee uc e during oouro e d e liv e r) 1 : In the event 
that an institution or agency does not own a required 
facility, written agreements with other entities must be made 
to assure use of and timely access to such facilities. A copy 
of such agreement must be on file for review by Standards 
Division staff. 

ft} firearms (handgun and shotgun), 

(3) firearm ammunition (praotio e and qualifying), 






motof vehicle, 
polio e baton, 



m- 



gas mask, 
handcuff s , or 



m — 

(7) radar, radar and time distance or time distance 

speed moaouromont instrum e nts. — 
(f) Th e oohool rules may requ i re the employing ag e noy or 
department to moke the equipment and supplies listed in 
Paragraph (o) of this Rule available at the appropriate 
ooh e dul e d time during oouro e deliv e ry for the us e of its own 
train ee offio e r s . Each institution or agency accredited to 
deliver basic recruit training shall provide access to supplies 
and equipment for trainee use during course delivery as 
specified in the Basic Law Enforcement Training Course 
Management Guide. 

Statutory Authority G.S. 17C-6. 

.0202 RESPONSIBILITIES OF THE SCHOOL 
DIRECTOR 

(a) In planning, developing, coordinating, and delivering 
each commission-accredited criminal justice Gaining course, 
the school director shall: 

(1) Formalize and schedule the course curriculum in 
accordance with the curriculum standards estab- 
lished by the Commission. 

(A) The school director shall schedule course 
presentation for delivery as follows: 

(i) Each basic training course required for 
criminal justice officer certification shall 
be presented with a minimum of 12 hours 
of instruction each week during consecu- 
tive calendar weeks except that there may 
be as many as three one-week breaks until 
course requirements are completed. This 
Rule shall not apply to presentations of the 
"Basic Training— State Youth Services 
Officers" course. 

(ii) The "Criminal Justice Instructor Training 
Course" shall be presented with a mini- 
mum of 40 hours of instruction each week 
during consecutive calendar weeks until 
course requirements are completed. 

(B) In the event of exceptional or emergency 
circumstances, the Director of the Standards 
Division may, upon written finding of justifi- 
cation, grant a waiver of the minimum hours 
requirement. 

(2) Select and schedule qualified instructors who are 
properly certified by the Commission. The 
selecting and scheduling of instructors is subject 
to special requirements as follows: 

(A) In the presentation of a delivery of the "Basic 

Recruit Training—Law Enforcement" course: 

(i) No instructor shall be scheduled to in s truct 

instruct, either as the lead instructor or in 

any other capacity, in a high liability topic 

area as identified under Rule .0304(a) of 



I 



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125 



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April 17, 1995 



10:2 



PROPOSED RULES 



m 



this Subchapter unless specifically certified 
for that topic area by the Commission. 
With the exception of the First Responder, 
Physical Fitness. Medical Emergencies 
(DYS), and Electrical and Hazardous 
Materials Emergencies topical areas as 
outlined in Rule .0304(a) of this Subchap- 
ter, there shall be one specific certified 
instructor for each six trainees while ac- 
tively engaged in a practical performance 



I 



(A) 
(B) 



(Q 



I 



(in) (£) No single individual may be scheduled 
to instruct more than 35 percent of the 
total hours of the curriculum during any 
one delivery of the "Basic Recruit Train- 
ing—Law Enforcement" course presenta- 
tion. 

(iv) {i«)Where the school director shows ex- 
ceptional or emergency circumstances and 
the school director documents that an (7) 

instructor is qualified to instruct more than 
35 percent of the total hours of the curric- (8) 

ulum, the Director of the Standards Divi- 
sion may grant written approval for the 
expansion of the individual instructional 
limitation. 
(B) In the presentation of a delivery of the "Crimi- 
nal Justice Instructor Training Course": (A) 
(i) At least one evaluator of trainee perfor- 
mance shall be scheduled for each six 
trainees and in course delivery no evalua- (B) 
tor will be assigned more than six trainees, 
(ii) Each evaluator, as well as the instructors, 
must have successfully completed a com- 
mission-accredited instructor training (C) 
course or an equivalent instructor training 
course as determined by the Commission. 

(iii) Each instructor and evaluator must docu- 
ment successful participation in a special (9) 
program presented by the Justice Academy 
for purposes of familiarization and supple- 
mentation relevant to delivery of the in- 
structor training course and trainee evalua- 
tion. (A) 

(3) Provide each instructor with a commis- 
sion-approved course outline and all necessary (B) 
additional information concerning the instruc- 
tor's duties and responsibilities. 

(4) Review each instructor's lesson plans and other (C) 
instructional materials for conformance to estab- 
lished commission standards and to minimize (D) 
repetition and duplication of subject matter. 

(5) Arrange for the timely availability of appropriate (E) 
audiovisual aids and materials, publications, 

facilities and equipment for training in all topic 
areas. 

(6) Develop, adopt, reproduce, and distribute any (10) 



supplemental rules, regulations, and require- 
ments determined by the school to be necessary 
or appropriate for: 
effective course delivery; 
establishing responsibilities and obligations of 
agencies or departments employing course 
trainees; and 

regulating trainee participation and demeanor 
and ensuring trainee attendance and maintain- 
ing performance records. 
A copy of such rules, regulations and require- 
ments shall be submitted to the Director of the 
Standards Division as an attachment to the 
Pre-delivery Report of Training Course Pre- 
sentation. A copy of such rules shall also be 
given to each trainee and to the executive 
officer of each trainee's employing agency or 
department at the time the trainee enrolls in 
the course. 
If appropriate, recommend bousing and dining 
facilities for trainees. 

Not less than 15 days before commencing deliv- 
ery of the "Basic Recruit Training—Law En- 
forcement" course, submit to the commission a 
Pre-delivery Report of Training Course Presen- 
tation (Form F-10A) along with the following 
attachments: 
A comprehensive course schedule showing 
arrangement of topical presentations and pro- 
posed instructional assignments. 
A copy of any rules, regulations, and require- 
ments for the school and, when appropriate, 
completed applications for Professional Lec- 
turer Certification. 

The Director of the Standards Division shall 
review the submitted Pre-delivery Report 
together with all attachments and notify the 
school director of any apparent deficiency. 
Not less than 30 days before commencing deliv- 
ery of the "Criminal Justice Instructor Training 
Course", submit to the commission a 
Pre-delivery Report of Training Course Presen- 
tation with the following attachments: 
The name and credentials of the school direc- 
tor. 

A comprehensive course schedule showing 
arrangement of topical presentations and pro- 
posed instructional assignments. 
The names and credentials of all instructors 
and e valuators. 

A copy of any rules, regulations, and require- 
ments for the school. 

The Director of the Standards Division shall 
review the submitted Pre-delivery Report 
together with all attachments and notify the 
school director of any apparent deficiency. 
Administer the course delivery in accordance 



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April 17, 1995 



126 



PROPOSED RULES 



with commission-approved procedures, guide- 
lines, and standards and ensure that the training 
offered is as effective as possible. 

(11) The school director or designated certified 
instructor shall monitor the presentations of all 
probationary instructors during course delivery 
and prepare formal written evaluations on their 
performance and suitability for subsequent 
instructional assignments. These evaluations 
shall be prepared on commission-approved forms 
and forwarded to the Commission. Based on 
this evaluation, the school director shall have the 
added responsibility for recommending approval 
or denial of requests for General Instructor 
Certification. 

(12) The school director or designated certified 
instructor shall monitor the presentations of all 
other instructors during course delivery and 
prepare formal written evaluations on their 
performance and suitability for subsequent 
instructional assignments. Any designated 
certified instructor who is evaluating the instruc- 
tional presentation of another instructor shall, at 
a minimum, hold certification in the same in- 
structional topic area as that for which the 
instructor is being evaluated. Instructor evalua- 
tions shall be prepared on commission-approved 
forms in accordance with commission standards. 
These evaluations shall be kept on file by the 
school for a period of three years and shall be 
made available for inspection by a representative 
of the Commission upon request. 

(13) Administer or designate a qualified person to 
administer appropriate tests as determined neces- 
sary at various intervals during course delivery: 

(A) to determine and record the level of trainee 
comprehension and retention of instructional 
subject-matter; and 

(B) to provide a basis for a final determination or 
recommendation regarding the minimum 
degree of knowledge and skill of each trainee 
to function as an inexperienced criminal justice 
officer; and 

(C) to determine subject or topic areas of defi- 
ciency for the application of Rule .0405(a)(3) 
of this Subchapter. 

(14) Maintain direct supervision, direction, and 
control over the performance of all persons to 
whom any portion of the planning, development, 
presentation, or administration of a course has 
been delegated. 

(15) During a delivery of the "Basic Recruit Train- 
ing—Law Enforcement" course, make available 
to authorized representatives of the Commission 
four hours of scheduled class time and class- 
room facilities for the administration of a written 
examination to those trainees who have satisfac- 
torily completed all course work. 



(16) Report the completion of each presentation of a 
commission-accredited criminal justice training 
course to the Commission as follows: 

(A) "Basic Recruit Training—Law Enforcement". 
Not more than 10 days after receiving from 
the Commission's representative the Report of 
Examination Scores, the school director shall 
submit to the Commission a Post-delivery 
Report of Training Course Presentation (Form 
F-10B). 

(B) Special arrangements shall be made between 
the school director and the Director of the 
Standards Division for the reporting of law 
enforcement achievement in a commis- 
sion-accredited Public Safety Officer course. 

(C) Upon successful completion of a commis- 
sion-accredited training course by correctional, 
state youth services, or probation/parole train- 
ees, the director of the school conducting such 
course shall notify the Commission of the 
satisfactory achievement of trainees by submit- 
ting a monthly Report of Training Course 
Completion. 

(D) "Criminal Justice Instructor Training Course". 
Not more than 10 days after course completion 
the school director shall submit to the Com- 
mission a Post-delivery Report containing the 
following: 

(i) Class enrollment roster, 
(ii) Course schedule with designation of in- 
structors and evaluators utilized in deliv- 
ery, 
(iii) Scores recorded for each trainee on both 
the 80 minute skill presentation and the 
final written examination, 
(iv) Designation of trainees who successfully 
complete the course in its entirety and 
whom the school director finds to be 
competent to instruct, 
(b) In addition to Paragraph (a) of this Rule, in planning, 
developing, coordinating and delivering each commis- 
sion-accredited radar, radar and time-distance or 
time-distance speed measurement operator training course or 
re-certification course, the school director shall: 

(1) select and schedule qualified radar or 
time-distance speed measurement instrument 
instructors who are properly certified by the 
Commission as instructors for the specific speed 
measurement instruments in which the trainees 
are to receive instruction. The following re- 
quirements apply to operator certification train- 
ing: 

(A) Provide to the instructor the Commission 
form(s) for motor-skill examination on each 
trainee; 

(B) Require the instructor to complete the mo- 
tor-skill examination form on each trainee 
indicating the level of proficiency obtained on 



♦ 



127 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



each specific instrument; 
(C) Require each instructor to sign each individual 
form and submit the original to the school 
director. 

(2) not less than 30 days before the scheduled 
starting date submit to the Director of the Stan- 
dards Division a Request for Training Course 
Presentation. 

(A) The request shall contain a period of course 
delivery including the proposed starting date, 
course location and the number of trainees to 
be trained in each type of approved 
speed-measurement instrument; 

(B) The Director of the Standards Division shall 
review the request and notify the school direc- 
tor of the accepted delivery period unless a 
conflict exists with previously scheduled pro- 
grams. 

(3) during the delivery of the training course, make 
available to authorized representatives of the 
Commission two hours of scheduled class time 
and classroom facilities for the administration of 
a written examination to the trainee. 

(4) upon completing delivery of the Commis- 
sion-accredited course, and not more than 10 
days after receiving from the Commission's 
representative the Report of Examination Scores, 
the school director shall notify the Commission 
regarding the progress and achievements of each 
trainee by submitting a Post-delivery Report of 
Training Course Presentation. This report shall 
include the original motor-skill examination 
form(s) completed and signed by the certified 
instructor responsible for administering the 
motor-skill examination to the respective trainee. 

Statutory Authority G.S. 17C-6. 

.0205 BASIC TRAINING - LAW ENFORCEMENT 
OFFICERS 

(a) The basic training course for law enforcement officers 
consists of instruction designed to provide the trainee with 
the skills and knowledge to perform those tasks essential to 
function in law enforcement. 

(b) The course entitled "Basic Recruit Training — Law 
Enforcement" shall consist of a minimum of 432 460 hours 
of instruction and shall include the following identified topic 
areas and minimum instructional hours for each area: 

(1) Course Orientation 2 Hours 

(2) Constitutional Law 4 Hours 

(3) Laws of Arrest, Search and Seizure 16 Hours 

(4) Mechanics of Arrest; Arrest 

Procedures 8 Hours 

(5) Law Enforcement Communications 

and Information Systems 4 Hours 

(6) Elements of Criminal Law 24 Hours 



(7) 


Defensive Tactics 


16 Hours 


(8) 


Juvenile Laws and Procedures 


8 Hours 


(9) 


First Responder 


40 Hours 


(10) 


Firearms 


40 Hours 


(11) 


Patrol Techniques 


16 Hours 


(12) 


Crime Prevention Techniques 


4 Hours 


(13) 


Field Notetaking and Report Writing 


12 Hours 


(14) 


Mechanics of Arrest; Vehicle Stops 


6 Hours 


(15) 


Mechanics of Arrest; Custody 






Procedures 


2 Hours 


(16) 


Mechanics of Arrest; Processing 






Arrestee 


4 Hours 


(17) 


Crisis Management 


10 Hours 


(18) 


Special Populations 


12 Hours 


(19) 


Civil Disorders 


8 Hours 


(20) 


Criminal Investigation 


28 Hours 


(21) 


Interviews: Field and In-Custody 


8 Hours 


(22) 


Controlled Substances 


6 Hours 


(23) 


ABC Laws and Procedures 


4 Hours 


(24) 


Electrical and Hazardous Materials 






Emergencies 


12 Hours 


(25) 


Motor Vehicle Laws 


20 Hours 


(26) 


Techniques of Traffic Law 






Enforcement 


6 Hours 


(27) 


Traffic Accident Investigation 


20 Hours 


(28) 


Law Enforcement Driver 






Training 44 


44 Hours 


(29) 


Preparing for Court and Testifying 






in Court 


12 Hours 


(30) 


Dealing with Victims and the Public 


4 Hours 


(31) 


Ethics of Professional Law 






Enforcement 


4 Hours 


(32) 


Testing 


13 Hours 


(33) 


Physical Fitness 


43 Hours 



(c) The "Basic Law Enforcement Training Manual" as 
published by the North Carolina Justice Academy is hereby 
incorporated by reference, and shall automatically include 
any later amendments and editions of the incorporated 
material as provided by G.S. 150B-21.6, to apply as basic 
curriculum for this basic training course for law enforce- 
ment officers as administered by the Commission. Copies 
of this publication may be inspected at the office of the 
agency: 

Criminal Justice Standards Division 

North Carolina Department of Justice 

1 West Morgan Street 

Court of Appeals Building 

Post Office Drawer 149 

Raleigh, North Carolina 27602 

and may be obtained for ninety-five dollars ($95.00) per 
copy from the Academy at the following address: 

North Carolina Justice Academy 
Post Office Drawer 99 



10:2 



NORTH CAROLINA REGISTER 



April 17, 1995 



128 



PROPOSED RULES 



Salemburg, North Carolina 28385 

(d) The "Basic Law Enforcement Training Course 
Management Guide" as published by the North Carolina 
Justice Academy is hereby incorporated by reference, and 
shall automatically include any later amendments and 
editions of the incorporated material as provided by G.S. 
150B-21.6, to be used by certified school directors in 
planning, implementing and delivering basic training 
courses. Each certified school director shall be issued a 
copy of the guide at the time of certification at no cost to 
the accredited school. The public may obtain copies of this 
guide from the Justice Academy for one dollar and sixty- 
five cents ($1.65) per copy. 



Total 



160 Hours 



(c) The "Basic Correction Officer Training Manual" as 
published by the Department of Correction is hereby 
adopted incorporated by reference, and shall automatically 
include any later amendments and editions of the adopted 
matter as authoriz e d by G.S. — 150B H(o) incorporated 
material as provided by G.S. 150B-21.6 , to apply as the 
basic curriculum for delivery of correctional officer basic 
training courses. 

(d) Commission-accredited schools that are accredited to 
offer the "Basic Training: Correctional Officers" course are: 
The Office of Staff Development and Training of the North 
Carolina Department of Correction. 



Statutory Authority G.S. 17C-6; 17C-10. 



Statutory Authority G.S. 17C-6; 17C-10. 



.0206 BASIC TRAINING - CORRECTIONAL 
OFFICERS 

(a) The basic training course for correctional officers 
shall consist of a minimum of 160 hours of instruction 
designed to provide the trainee with the skills and knowl- 
edge to perform those tasks essential to function as a 
correctional officer. 

(b) Each basic training course for correctional officers 
shall include the following identified topic areas and 
minimum instructional hours for each area; however, the 
director is authorized to permit modification of the topical 
areas and minimum instructional hours, not inconsistent with 
a minimum of 160 hours of instruction, on an interim basis 
with such modifications to be submitted to the Standards 
Committee and the full commission at their next regularly 
scheduled meeting: 



(1) 

(2) 

(3) 

(4) 
(5) 

(6) 

(7) 
(8) 
(9) 

(10) 
(11) 
(12) 
(13) 
(14) 
(15) 
(16) 
(17) 

(18) 



The Division of Prisons Employee 2 Hours 
Prison Security Functions and 

Procedures 4 

Contraband and Techniques of Search 8 



Inmate Supervision 8 

Firearms 24 
Inmate Classification Process and 

Programs 4 

Understanding Inmate Behavior 12 

Prison Emergency Operations 18 
Radio Communications, 

Transporting, and Restraints 4 

Basic Life Support 12 

Prison Health Services 2 

Report Writing 6 

You and the Law 4 

Interpersonal Communication Skills 16 

Unarmed Self Defense 18 

Role of the Correctional Witness 4 
Disciplinary and Inmate Grievance 

Procedures 4 Hours 
Administrative Matters, Review 

and Testing 10 Hours 



Hours 
Hours 
Hours 
Hours 

Hours 
Hours 
Hours 

Hours 
Hours 
Hours 
Hours 
Hours 
Hours 
Hours 
Hours 



.0210 RADAR INSTRUCTOR TRAINING COURSE 

(a) The radar instructor training course required for radar 
instructor certification shall consist of a minimum of 62 
hours of instruction presented within a period not to exceed 
six consecutive weeks. 

(b) Each radar instructor training course shall be designed 
to provide the trainee with the skills and knowledge to 
proficiently perform the function of a criminal justice radar 
instructor. 

(c) Each applicant for radar instructor training shall: 

(1) Present the endorsement of a commis- 
sion-recognized school director or agency execu- 
tive officer or his designee. 

(2) Possess criminal justice general instructor certifi- 
cation as required in 12 NCAC 9B .0302. 

(d) Each radar instructor training course shall include but 
not be limited to the following topic areas and corresponding 
instructional hours and incorporate the corresponding 
minimum trainee performance objectives within the course 
curriculum: 

(1) Course Orientation 2 Hours 

(A) description of the course content; 

(B) outline of the performance requirements for 
successful completion of the radar instructor 
training program. 

(2) North Carolina Administrative Code: 2 Hours 
Familiarization with the code as to radar training 
courses and certification requirements, to include 
completion of the forms that pertain to speed 
measurement instrument training. 

(3) Overview and Introduction to Radar 
Training 4 Hours 

(A) description of the objectives of a radar training 
program; 

(B) identification of specific requirements for radar 
instructors, operators and equipment as set 
forth in the Radar Reliability Act (G.S. 17C 
and G.S. 8-50.2); 

(4) Speed Offenses and Speed 

Enforcement 6 Hours 

(A) description in quantitative and qualitative terms 



♦ 



129 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



the association between speed offenses and 
motor vehicle accidents; 

(B) description of major types of speed regula- 
tions, including origin, development, and 
scope of these regulations; 

(C) description in quantitative and qualitative terms 
the safety benefits of effective speed enforce- 
ment in general and 55 mph in particular. 

(5) Basic Principles of Radar Speed 
Measurement 6 Hours 

(A) description of the basic operating principles of 
a stationary and moving radar instrument; 

(B) explanation of the Doppler Principle in terms 
of how a radar signal is changed by reflection 
off a moving object; 

(C) description of factors that can affect radar 
accuracy and effectiveness. 

(6) Legal and Operational Considerations 8 Hours 

(A) identification and description of fundamental 
case law affecting the use of radar for speed 
measurement and enforcement; 

(B) demonstration of basic skills in preparing and 
presenting evidence and testimony concerning 
speed enforcement and radar speed measure- 
ment; 

(C) description and application of required operat- 
ing procedures of radar instruments. 

(7) Classroom Familiarization with Specific Radar 
Instruments: 8 Hours 

demonstration of familiarity with the functions and 
operating procedures of approved radar instru- 
ments. 

(8) Moot Court 6 Hours 

(A) preparation of complete, concise and effective 
direct testimony for radar cases; 

(B) respond properly and effectively to cross 
examination. 

(9) Field Operation of Specific Radar 
Instrument 8 Hours 

(A) description of the functional components of 
approved radar units; 

(B) description of the setup, calibration, and 
operation procedures of approved radar units; 

(C) operation and performance of all procedural 
requirements of actual patrol with approved 
radar units. 

(10) Motor-Skill Performance Testing: 8 Hours 

(A) demonstration of the ability to successfully 
setup, calibrate and operate approved radar 
instruments for which the trainee seeks certifi- 
cation in accordance with criteria specified on 
a standardized trainee performance evaluation 
form; 

(B) demonstration of the ability to estimate vehicu- 
lar speed in accordance with criteria specified 
on a standardized trainee performance evalua- 
tion form. 



(11) 
(12) 



Course Review 
Written Test 



2 Hours 
2 Hours 



Total 



62 Hours 



(e) The "Radar Operator Training Course" as published 
by the North Carolina Justice Academy is hereby adopt e d 
incorporated by reference, and shall automatically include 
any later amendments and editions of the adopted matter as 
authoriz e d by G.S. 150B H(o) incorporated material as 
provided by G.S. 150B-21.6 . to apply as basic curriculum 
for the radar instructor training course for radar instructors 
as administered by the Commission. Copies of this publica- 
tion may be inspected at the office of the agency: 

Criminal Justice Standards Division 

North Carolina Department of Justice 

1 West Morgan Street 

Court of Appeals Building 

Post Office Drawer 149 

Raleigh, North Carolina 27602 

and may be obtained at cost at the address in this Rule. 

(f) Commission-accredited schools that are accredited to 
offer the "Radar Instructor Training Course" are: The 
North Carolina Justice Academy. 

Statutory Authority G.S. 17C-6. 

.0212 CERTIFICATION TRAINING FOR RADAR 
OPERATORS 

(a) The radar operator training course for law enforce- 
ment officers shall consist of a minimum of 32 hours of 
instruction designed to provide the trainee with the skills and 
knowledge to proficiently perform those tasks essential to 
function as a radar operator. This course shall be for a 
period not to exceed four consecutive weeks. 

(b) Only employed or appointed personnel of a law 
enforcement agency shall be enrolled in the radar operator 
training course. Such a trainee shall not be certified as a 
radar operator until the basic law enforcement training 
course has been successfully completed and probationary or 
general law enforcement certification has been granted. 
Sheriffs, deputy sheriffs and federal law enforcement 
personnel, including but not limited to armed forces person- 
nel, shall be allowed to participate in radar operator training 
courses on a space available basis at the discretion of the 
school director without having enrolled in or having success- 
fully completed the basic law enforcement training course 
and without being currently certified in a probationary status 
or hold general law enforcement certification. 

(c) Each radar operator training course for law enforce- 
ment officers shall include the following topic areas and 
corresponding instructional hours and incorporate the 
corresponding minimum trainee performance objectives 
within the course curriculum: 

(1) Course Orientation: 1 Hour 

(A) description of the course content; 

(B) outline of the performance requirements for 



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PROPOSED RULES 



successful completion of the radar operator 
training program. 

(2) Speed Offenses and Speed 

Measurement: 3 Hours 

(A) description in quantitative and qualitative terms 
the association between speed offenses and 
motor vehicle accidents; 

(B) description of major types of speed regula- 
tions, including origin, development, and 
scope of these regulations; 

(C) description in quantitative and qualitative terms 
the safety benefits of effective speed enforce- 
ment in general. 

(3) Basic Principles of Radar Speed 
Measurement: 5 Hours 

(A) description of the basic operating principles of 
a stationary and moving radar instrument; 

(B) explanation of the Doppler Principle in terms 
of how a radar signal is changed by reflection 
off a moving object; 

(C) description of factors that can affect radar 
accuracy and effectiveness. 

(4) Legal and Operational Considerations: 4 Hours 

(A) identification and description of fundamental 
case law affecting the use of radar for speed 
measurement and enforcement; 

(B) demonstration of basic skills in preparing and 
presenting evidence and testimony concerning 
speed enforcement and radar speed measure- 
ment; 

(C) description and application of accepted operat- 
ing procedures of radar instruments; 

(D) demonstration of the ability to estimate vehicu- 
lar speed in accordance with criteria specified 
on a standardized trainee performance evalua- 
tion form. 

(5) Classroom Familiarization with Specific Radar 
Instruments: 2 Hours 
demonstration of familiarity with the functions 
and operating procedures of radar instruments 
for which the trainee seeks certification. 

(6) Moot Court: 4 Hours 

(A) preparation of complete, concise and effective 
direct testimony for radar cases; 

(B) respond properly and effectively to cross 
examination 

(7) Supervised/Monitored Practice with Specific 
Radar Instruments: 6 Hours 

(A) description of the functional components of the 
radar units for which the trainee seeks certifi- 
cation; 

(B) description of the setup, calibration, and 
operation procedures of the radar units for 
which the trainee seeks certification; 

(C) operation and performance of all procedural 
requirements of actual patrol with the radar 
units for which the trainee seeks certification. 

(8) Motor-Skill Performance Testing: 4 Hours 



(9) 
(10) 



demonstration of the ability to successfully 
setup, calibrate and operate the radar instru- 
ments for which the trainee seeks certification in 
accordance with criteria specified on a standard- 
ized trainee performance evaluation form. 
Course Review 1 Hour 

Written Test. 2 Hours 



Total 



32 Hours 



(d) The "Radar Operator Training Course" as published 

by the North Carolina Justice Academy is hereby adopted 

incorporated by reference, and shall automatically include 

any later amendments and editions of the adopted matter an 

authoriz e d by G.S. 150B H(o) incorporated material as 

provided by G.S. 150B-21.6 . to apply as basic curriculum 

for the radar operator training course for radar operators as 

administered by the Commission. Copies of this publication 

may be inspected at the office of the agency: 

Criminal Justice Standards Division 

North Carolina Department of Justice 

1 West Morgan Street 

Court of Appeals Building 

Post Office Drawer 149 

Raleigh, North Carolina 27602 

and may be obtained at cost at the address in this Rule. 

Statutory Authority G.S. 17C-6. 

.0213 CERTIFICATION TRAINING FOR RADAR 
TD/SMI OPERATORS 

(a) Each radar and time-distance speed measurement 
instrument operator training course for law enforcement 
officers shall consist of a minimum of 48 hours of instruc- 
tion designed to provide the trainee with the skills and 
knowledge to proficiently perform those tasks essential to 
function as a radar and time-distance speed measurement 
instrument operator. This course shall be for a period not 
to exceed four consecutive weeks. 

(b) Only employed or appointed personnel of a law 
enforcement agency may be enrolled in the radar and 
time-distance speed measurement instrument operator 
training course. Such a trainee shall not be certified as a 
radar and time-distance speed measurement instrument 
operator until the basic law enforcement training course has 
been successfully completed and probationary or general law 
enforcement certification has been granted. Sheriffs, deputy 
sheriffs, and federal law enforcement personnel, including 
but not limited to armed forces personnel, shall be allowed 
to participate in radar and time-distance speed measurement 
instrument operator training courses on a space available 
basis at the discretion of the school director without having 
enrolled in or having successfully completed the basic law 
enforcement training course and without being currently 
certified in a probationary status or holding general law 
enforcement certification. 

(c) Each combined radar and time-distance speed mea- 
surement instrument operators' training course shall include 



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PROPOSED RULES 



all topic areas specified in 12 NCAC 9B .0212(c). The 
additional 16 instructional hours in the time-distance speed 
measurement instrument operators' training course shall 
include but not be limited to the following topic areas and 
corresponding instructional hours and incorporate the 
corresponding minimum trainee performance objectives 
within the course curriculum: 

(1) Basic Principles of Time-Distance Speed Mea- 
surement Instruments: 1 Hour 

(A) description of the basic principles on which 
time-distance speed measurement instruments 
operate; 

(B) explanation of the procedures used in calibrat- 
ing time-distance speed measurement instru- 
ments; 

(C) description of the basic operating procedures 
required when employing time-distance speed 
measurement instruments. 

(2) Legal and Operational Considerations of 
Tune-Distance Speed Measurement Instruments: 

2 Hours 

(A) identification and description of fundamental 
case law affecting the use of time-distance 
speed measurement for speed enforcement; 

(B) identification and description of accepted 
operating procedures for the proper use of 
time-distance speed measurement instruments; 

(C) identification and description of factors which 
may affect the selection of various speed 
measurement sites. 

(3) Classroom Familiarization with Specific 
Tune-Distance Speed Measurement Instruments: 

2 Hours 
demonstration of familiarity with the functions 
and operating procedures time-distance speed 
measurement instruments) for which the trainee 
seeks certification. 

(4) Moot Court: 2 Hours 

(A) preparation of complete, concise and effective 
direct testimony for time-distance speed mea- 
surement instrument cases; 

(B) respond properly and effectively to cross 
examination. 

(5) Supervised/Monitored Practice with Specific 
Time-Distance Speed Measurement 
Instruments: 5 Hours 

(A) description of the functional components of the 
time-distance speed measurement instrument(s) 
for which the trainee seeks certification; 

(B) description of the setup, calibration and opera- 
tion procedures of the time-distance speed 
measurement instrument(s) for which the 
trainee seeks certification; 

(C) operation and performance of all procedural 
requirements of actual patrol with the 
time-distance speed measurement instrument 
for which the trainee seeks certification. 



(6) 



Motor-Skill Performance Testing: 4 Hours 

demonstration of the ability to successfully 
setup, calibrate and operate the time-distance 
speed measurement instrument(s) for which the 
trainee seeks certification in accordance with 
criteria specified on a standardized trainee 
performance evaluation form. 



Total 



16 Hours 



(d) The "Time-Distance Operator Course" as published 
by the North Carolina Justice Academy is hereby adopted 
incorporated by reference, and shall automatically include 
any later amendments and editions of the adopted matt e r a s 
authorized by G.S. 150B 14(o) incorporated material as 
provided by G.S. 150B-21.6 , to apply as basic curriculum 
for the radar and time-distance speed measurement instru- 
ment operator training course for radar and time-distance 
speed measurement instrument operators as administered by 
the Commission. Copies of this publication may be in- 
spected at the office of the agency: 

Criminal Justice Standards Division 

North Carolina Department of Justice 

1 West Morgan Street 

Court of Appeals Building 

Post Office Drawer 149 

Raleigh, North Carolina 27602 

and may be obtained at cost at the address in this Rule. 

Statutory Authority G.S. 17C-6. 

.0214 CERTIFICATION TRAINING FOR TD/SMI 
OPERATORS 

(a) The time-distance speed measurement operator 
training course for law enforcement officers shall consist of 
a minimum of 32 hours of instruction designed to provide 
the trainee with the skills and knowledge to proficiently 
perform those tasks essential to function as a time-distance 
speed measurement operator. This course shall not exceed 
four consecutive weeks. 

(b) Only employed or appointed personnel of a law 
enforcement agency may be enrolled in the time-distance 
speed measurement operator training course. Such a trainee 
shall not be certified as a time-distance speed measurement 
operator until the basic law enforcement training course has 
been successfully completed and probationary or general law 
enforcement certification has been granted. Sheriffs, deputy 
sheriffs, and federal law enforcement personnel, including 
but not limited to armed forces personnel, shall be allowed 
to participate in time-distance speed measurement operator 
training courses on a space available basis at the discretion 
of the school director without having enrolled in or having 
successfully completed the basic law enforcement training 
course and without being currently certified in a probation- 
ary status or holding general law enforcement certification. 

(c) Each time-distance speed measurement instrument 
operator training course for law enforcement officers shall 



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132 



PROPOSED RULES 



include the following topic areas and corresponding instruc- 
tional hours and incorporate the corresponding minimum 
student performance objectives within the course curricu- 
lum: 

(1) Course Orientation: 1 Hour 

(A) description of the course content; 

(B) outline of the performance requirements for 
successful completion of the time-distance 
speed measurement instrument operator train- 
ing program. 

(2) Speed Offenses and Speed 

Measurement: 3 Hours 

(A) description in quantitative and qualitative terms 
the association between speed offenses and 
motor vehicle accidents; 

(B) description of major types of speed regula- 
tions, including origin, development, and 
scope of these regulations; 

(C) description in quantitative and qualitative terms 
the safety benefits of effective speed enforce- 
ment in general. 

(3) Basic Principles of Time-Distance Speed Mea- 
surement: 2 Hours 

(A) description of the basic operating principles of 
electronic time-distance speed measurement 
instruments; 

(B) description of factors that can affect electronic 
time-distance speed measurement instrument 
accuracy and effectiveness. 

(4) Legal and Operational Considerations: 4 Hours 

(A) identification and description of fundamental 
case law affecting the use of time-distance 
speed measurement for speed enforcement; 

(B) description and application of accepted operat- 
ing procedures of time-distance speed measure- 
ment instruments; 

(C) demonstration of the ability to estimate vehicu- 
lar speed in accordance with criteria specified 
on a standardized trainee performance evalua- 
tion form. 

(5) Classroom Familiarization with Specific 
Time-Distance Speed Measurement 
Instruments: 2 Hours 
demonstration of familiarity with the functions 
and operating procedures of time-distance speed 
measurement instruments for which the trainee 
seeks certification. 

(6) Moot Court: 4 Hours 

(A) preparation of complete, concise and effective 
direct testimony for time-distance speed mea- 
surement cases; 

(B) respond properly and effectively to cross 
examination; 

(C) demonstration of basic skills in preparing and 
presenting evidence and testimony concerning 
speed enforcement and time-distance speed 
measurement. 

(7) Supervised/Monitored Practice with Specific 



Time-Distance Speed Measurement 
Instruments: 8 Hours 

(A) description of the functional components of the 
time-distance speed measurement units for 
which the trainee seeks certification; 

(B) description of the setup, calibration, and 
operation procedures of the time-distance 
speed measurement units for which the trainee 
seeks certification; 

(C) operation and performance of all procedural 
requirements of actual patrol with the 
time-distance speed measurement units for 
which the trainee seeks certification. 

(8) Motor-Skill Performance Testing: 5 Hours 
demonstration of the ability to successfully 
setup, calibrate and operate the time-distance 
speed measurement instruments for which the 
trainee seeks certification in accordance with 
criteria specified on a standardized trainee 
performance evaluation form. 

(9) Course Review 1 Hour 
(10) Written Test 2 Hours 



Total 



32 Hours 



(d) The "Time-Distance Operator Course" as published 

by the North Carolina Justice Academy is hereby adopted 

incorporated by reference, and shall automatically include 

any later amendments and editions of the adopted matter as 

authoriz e d by G.S. 150B M(o) incorporated material as 

provided by G.S. 150B-21.6 , to apply as basic curriculum 

for the time-distance speed measurement operator training 

course for time-distance speed measurement operators as 

administered by the Commission. Copies of this publication 

may be inspected at the office of the agency: 

Criminal Justice Standards Division 

North Carolina Department of Justice 

1 West Morgan Street 

Court of Appeals Building 

Post Office Drawer 149 

Raleigh, North Carolina 27602 

and may be obtained at cost at the address in this Rule. 

Statutory Authority G.S. 17C-6. 

.0226 SPECIALIZED INSTRUCTOR TRAINING - 
FIREARMS 

(a) The instructor training course requirement for special- 
ized firearms instructor certification shall consist of a 
minimum of 83 hours of instruction presented during a 
continuous period of not more than two weeks. 

(b) Each specialized firearms instructor training course 
shall be designed to provide the trainee with the skills and 
knowledge to perform the function of a criminal justice 
firearms instructor in a "Basic Recruit Training — Law 
Enforcement" course or a "Law Enforcement Officers's 
In-Service Firearms Training and Qualification Program". 

(c) Each applicant for specialized firearms instructor 



< 



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PROPOSED RULES 



training shall: 

(1) have completed the criminal justice general 
instructor training course; and, 

(2) present a written endorsement by a certified 
school director indicating the student will be 
utilized to instruct firearms in "Basic Recruit 
Training— Law Enforcement" courses; or 

(3) present a written endorsement by a department 
head or certified school director indicating the 
student will be utilized to instruct firearms in a 
"Law Enforcement Officer's In-Service Firearms 
Training and Qualification Program"; and, 

(4) possess a current valid CPR Certification. 

(d) Each specialized firearms instructor training course 
shall include as a minimum the following identified topic 
areas and minimum instructional hours for each area: 



(1) 
(2) 
(3) 
(4) 
(5) 
(6) 
(7) 
(8) 
(9) 
(10) 

(11) 
(12) 
(13) 



Orientation/ Pretest 

Range Operations 

Civil Liability 

Night Firing 

Combat Shooting 

Mental Conditioning 

Shotgun Operation and Firing 



8 Hours 
38 Hours 
4 Hours 
2 Hours 
8 Hours 
1 Hour 
4 Hours 

Service Handgun - Operation and Use 5 Hours 
Rifle - Operation and Maintenance 4 Hours 
Service Handgun - Maintenance and 
Cleaning 2 Hours 

Range Medical Emergencies 2 Hours 

In-Service Firearms Requirements 2 Hours 
BLET Lesson Plan Review/Post Test 3 Hours 



(e) The "Specialized Firearms Instructor Training Man- 
ual" as published by the North Carolina Justice Academy is 
hereby adopted incorporated by reference, and shall auto- 
matically include any later amendments and editions of the 
adopted matter a s authorized by G.S. 150B 1 4 (c) incorpo- 
rated material as provided by G.S. 150B-21.6 . to apply as 
the basic curriculum for delivery of specialized firearms 
instructor training courses. Copies of this publication may 
be inspected at the agency: 

Criminal Justice Standards Division 

North Carolina Department of Justice 

1 West Morgan Street 

Court of Appeals Building 

Post Office Drawer 149 

Raleigh, North Carolina 27602 

(f) Commission-accredited schools that are accredited to 
offer the "Specialized Instructor Training - Firearms" course 
are: The North Carolina Justice Academy. 

Statutory Authority G.S. 17C-6. 



(2) 



(3) 
(4) 



(5) 



35 hours of instruction presented during a continuous period 
of not more than one week. 

(b) Each specialized driver instructor training course shall 
be designed to provide the trainee with the skills and 
knowledge to perform the function of a criminal justice 
driver instructor in a "Basic Recruit Training - Law En- 
forcement" course. 

(c) Each applicant for specialized driver instructor 
training shall: 

(1) have completed the criminal justice general 
instructor training course; 
present a written endorsement by a certified 
school director indicating the student will be 
utilized to instruct driving in "Basic Recruit 
Training— Law Enforcement" courses; 
possess a valid operator driver's license; 
maintain a safe driving record where no more 
than four points have been assigned against the 
driving record within the past three years; and, 
possess a current valid CPR Certification. 

(d) Each specialized driver instructor training course shall 
include as a minimum the following identified topic areas 
and minimum instructional hours for each area: 

(1) Orientation 

(2) Lesson Plan Review (BLET) 

(3) General Mechanical Knowledge 

(4) Before - Operation Inspection 

(5) Laws of Natural Force & 
Operating Characteristics 

(6) Driver Practicum 

(7) Fundamentals of Professional 
Liability for Trainers 

(8) Course Review/State Exam 

(e) The "Specialized Driver Instructor Training Manual" 
as published by the North Carolina Justice Academy is 
hereby adopted incorporated by reference, and shall auto- 
matically include any later amendments and editions of the 
adopt e d matt e r ao authoriz e d by G.S. 150B M(o) incorpo- 
rated material as provided by G.S. 150B-21.6 . to apply as 
the basic curriculum for delivery of specialized driver 
instructor training courses. Copies of this publication may 
be inspected at the agency: 

Criminal Justice Standards Division 

North Carolina Department of Justice 

1 West Morgan Street 

Court of Appeals Building 

Post Office Drawer 149 

Raleigh, North Carolina 27602 

(f) Commission-accredited schools that are accredited to 
offer the "Specialized Instructor Training - Driving" course 
are: The North Carolina Justice Academy and The North 
Carolina State Highway Patrol . 



1 Hour 


4 Hours 


2 Hours 


1 Hour 


4 Hours 


6 Hours 


4 Hours 


3 Hours 



.0227 SPECIALIZED INSTRUCTOR TRAINING - 
DRIVING 

(a) The instructor training course required for specialized 
driver instructor certification shall consist of a minimum of 



Statutory Authority G.S. 17C-6. 



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134 



PROPOSED RULES 



.0228 BASIC TRAINING - WILDLIFE 
ENFORCEMENT OFFICERS 

(a) The basic training course for wildlife enforcement 
officers appointed by the Wildlife Resources Commission as 
authorized under General Statute 113-136 shall consist of a 
minimum of 556 hours of instruction designed to provide 
the trainee with the skills and knowledge to perform those 
tasks essential to function as a wildlife enforcement officer. 

(b) Each basic training course for wildlife enforcement 
officers shall include the following identified topical areas 
and minimum instructional hours for each area: 



2 Hours 

8 Hours 

6 Hours 

2 Hours 

60 Hours 

as published by 

Commission is 

and shall auto- 



(1) 
(2) 
(3) 

(4) 

(5) 

(6) 
(7) 
(8) 
(9) 
(10) 

(ID 
(12) 
(13) 
(14) 
(15) 
(16) 
(17) 
(18) 
(19) 

(20) 
(21) 

(22) 
(23) 
(24) 

(25) 

(26) 
(27) 

(28) 
(29) 
(30) 
(31) 
(32) 

(33) 

(34) 
(35) 
(36) 



Course Orientation 2 Hours 

Constitutional Law 4 Hours 

Laws of Arrest, Search and 

Detention 16 Hours 

Mechanics of Arrest, Arrest 

Procedures 8 Hours 

Law Enforcement Communications 

and Information System 4 Hours 

Elements of Criminal Law 24 Hours 

Defensive Tactics 32 Hours 

Juvenile Law and Procedures 8 Hours 

First Responder 40 Hours 

Firearms 40 Hours 

Hunter Safety 10 Hours 

Patrol Techniques 16 Hours 

Field Notetaking and Report Writing 12 Hours 

Crisis Management 10 Hours 

Criminal Investigation 12 Hours 

Interviews; Field and In-Custody 8 Hours 

Controlled Substances 6 Hours 

ABC Laws and Procedures 4 Hours 

Electrical and Hazardous Materials 

Emergencies 12 Hours 

Law Enforcement Drivers Training 40 Hours 

Preparing for Court and Testifying 

in Court 12 Hours 

Game and Fish Laws 36 Hours 

Motorboat Laws 12 Hours 

Boating Procedures & Small Boat 

Handling 20 Hours 

Dealing with Problem Animal 

Situations 4 Hours 

Basic Field Identification of Fishes 6 Hours 

Basic Field Identification of Game Animals, 

Game Birds and Non-Game Animals 2 Hours 

Identification of Migratory Waterfowl 2 Hours 

Endangered Species 2 Hours 

Trapping 8 Hours 

Water Safety and Swimming 16 Hours 

Knotsmanship, A Practical Use of 

Rope 2 Hours 

Wildlife Law Enforcement and the 

Media 8 Hours 

Motorboat Accident Investigation 12 Hours 

Civil Disorders 12 Hours 

Radiological Monitoring 16 Hours 



(37) Covert Activities 

(38) Basic Photography 

(39) Motor Vehicle Laws 

(40) DWI Enforcement 

(41) Physical Training 

(c) The "Wildlife Basic Training Manual" 
the North Carolina Wildlife Resources 
hereby adopted incorporated by reference, 
matically include any later amendments and editions of the 
adopted matter ao authorized by G.S. 150B 14(o) incorpo- 
rated material as provided by G.S. 150B-21.6 . to apply as 
the basic curriculum for delivery of wildlife enforcement 
officer basic training courses. 

(d) Commission-accredited schools that are accredited to 
offer the "Basic Training: Wildlife Enforcement Officers" 
course are: The Division of Enforcement Training Office 
of the North Carolina Wildlife Resources Commission. 

Statutory Authority G.S. 17C-6; 17C-10. 

.0232 SPECIALIZED INSTRUCTOR TRAINING - 
DEFENSIVE TACTICS 

(a) The instructor training course required for specialized 
defensive tactics instructor certification shall consist of a 
minimum of 40 hours of instruction presented during a 
continuous period of not more than one week. 

(b) Each specialized defensive tactics instructor training 
course shall be designed to provide the trainee with the 
skills and knowledge to perform the function of a criminal 
justice defensive tactics instructor in a "Basic Recruit 
Training—Law Enforcement" course. 

(c) Each applicant for specialized defensive tactics 
instructor training shall: 

(1) have completed the criminal justice general 
instructor training course; 

(2) present a letter from a licensed physician stating 
the applicant's physical fitness to participate in 
the course; 

(3) present a written endorsement by a certified 
school director indicating the student will be 
utilized to instruct defensive tactics in "Basic 
Recruit Training—Law Enforcement" courses; 
and, 

(4) possess a current valid CPR Certification. 

(d) Each specialized defensive tactics instructor training 
course shall include as a minimum the following identified 
topic areas and minimum instructional hours for each area: 

(1) Orientation/Pretest 4 Hours 

(2) Civil Liability 4 Hours 

(3) Response to Injury 4 Hours 

(4) Safety Rules 2 Hours 

(5) Lesson Plan Review (BLET) 2 Hours 

(6) Defensive Tactics Instructional 

Methods 24 Hours 

(e) The "Specialized Defensive Tactics Instructor Training 
Manual" as published by the North Carolina Justice Acad- 
emy is hereby adopted incorporated by reference, and shall 
automatically include any later amendments and editions of 



♦ 



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10:2 



PROPOSED RULES 



the adopted matter as authorized by G.S. — 150B 1 4 (c) 
incorporated material as provided by G.S. 150B-21.6 , to 
apply as the basic curriculum for delivery of specialized 
defensive tactics instructor training courses. Copies of this 
publication may be inspected at the agency: 

Criminal Justice Standards Division 

North Carolina Department of Justice 

1 West Morgan Street 

Court of Appeals Building 

Post Office Drawer 149 

Raleigh, North Carolina 27602 

(f) Commission-accredited schools that are accredited to 

offer the "Specialized Instructor Training - Defensive 

Tactics" course are: The North Carolina Justice Academy. 

Statutory Authority G.S. 17C-6. 

.0233 SPECIALIZED INSTRUCTOR TRAINING - 
PHYSICAL FITNESS 

(a) The instructor training course required for specialized 
physical fitness instructor certification shall consist of a 
minimum of 40 hours of instruction presented during a 
continuous period of not more than one week. 

(b) Each specialized physical fitness instructor training 
course shall be designed to provide the trainee with the 
skills and knowledge to perform the function of a criminal 
justice physical fitness instructor in a "Basic Recruit 
Training — Law Enforcement" Course. 

(c) Each applicant for specialized physical fitness training 
shall: 

(1) qualify through one of the following three 
options: 

(A) have completed the criminal justice general 
instructor training course; or 

(B) hold a current and valid North Carolina 
Teacher's Certificate and hold a minimum of 
a baccalaureate degree in physical education 
and be actively teaching in physical education 
topics; or 

(C) be presently instructing physical education 
topics in a community college, college or 
university and hold a minimum of a baccalau- 
reate degree in physical education; and 

(2) present a written endorsement by a certified 
school director indicating the student will be 
utilized to instruct physical fitness in "Basic 
Recruit Training — Law Enforcement" courses; 
and 

(3) present a letter from a physician stating fitness 
to participate in the course; and, 

(4) possess a current valid CPR Certification. 

(d) Each specialized physical fitness instructor training 
course shall include as a minimum the following identified 
topic areas and minimum instructional hours for each area: 

(1) Orientation 1 Hour 

(2) Lesson Plan Review 2 Hours 

(3) Physical Fitness Assessments, 



Exercise Programs and Instructional 

Methods 26 Hours 

(4) Injury Care and Prevention 3 Hours 

(5) Nutrition 3 Hours 

(6) Civil Liabilities for Trainers 3 Hours 

(7) Examination 2 Hours 

(e) The "Physical Fitness Instructor Training Manual" as 
published by the North Carolina Justice Academy is hereby 
adopted incorporated by reference, and shall automatically 
include any later amendments and editions of the adopt e d 
matter as authoriz e d by G.S. — 1S0B 14(o) incorporated 
material as provided by G.S. 150B-21.6 , to apply as the 
basic curriculum for delivery of specialized physical fitness 
instructor training courses. Copies of this publication may 
be inspected at the agency. 

Criminal Justice Standards Division 

North Carolina Department of Justice 

1 West Morgan Street 

Court of Appeals Building 

Post Office Drawer 149 

Raleigh, North Carolina 27602 

(f) Commission-accredited schools that are accredited to 
offer the "Specialized Instructor Training — Physical 
Fitness" course are: The North Carolina Justice Academy. 

Statutory Authority G.S. 17C-6. 

SUBCHAPTER 9C - ADMINISTRATION OF 

CRIMINAL JUSTICE EDUCATION AND 

TRAINING STANDARDS 

SECTION .0400 - ACCREDITATION OF 

CRIMINAL JUSTICE SCHOOLS AND 

TRAINING COURSES 

.0401 ACCREDITATION OF CRIMINAL JUSTICE 
SCHOOLS 

(a) Any oohool m ee ting th e minimum roquirem e nto 
oontninod in 12 NCAC 9 - B .0200 and submitting a prop e rly 
completed Request — for School Accreditation — shall bo 
accredited — to provide criminal justice training courses. 
Accr e ditation of a s chool shall r e main e ff e ctiv e for two 
y e ars from ioonano e unl e ss e arli e r susp e nded or revoked The 
Commission shall establish a standing subcommittee of the 
Education and Training Committee for the purposes of 
evaluating Request for School Accreditation applications and 
making recommendations to the Education and Training 
committee on the granting of accreditation to institutions and 
agencies. The Accreditation Committee shall be comprised 
of two members appointed by the School Directors' Advi- 
sory Committee and two members who shall be commission 
members to include the North Carolina De partment of 
Community Colleges' representative to the Commission. 
The Chairman of the Commission shall a ppoint the Chair- 
man of the Accreditation Committee . 

(b) Any existing Commission-issued accreditations issued 
and valid on January 1± 1996 are automatically extended 



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136 



PROPOSED RULES 



with an expiration date of December 31. 1996. Previously 
issued accreditations with established expiration dates 
extending beyond December 31. 1996 are declared to be 
terminated and void on and after December 31. 1996. All 
new applicants for school accreditation shall meet the 
requirements of this section after January l± 1996. 

(c) A sohool may r e new its accreditation biennially by 
submitting an updated Request fo f School Accreditation. 
Any school meeting the minimum requirements contained in 
J_2 NCAC 9B .0200 must submit a properly completed 
Request for School Accreditation application. Upon receipt 
of a properly completed Request for School Accreditation 
application; 

(1) The Standards Division staff shall review the 
application for any omissions and clarifications 
and conduct a site visit to tour facilities, confirm 
information on the a pplication, and determine if 
and where deficiencies exist; 

(2) The a pplying institution or agency shall be 
contacted concerning deficiencies and assistance 
shall be given on correcting problem areas; 

(3) The application and staff reports are submitted 
to the Accreditation Committee for review; 

(4) A recommendation shall be submitted to the 
Education and Training Committee on the ap- 
proval or denial of the application; and 

(5) The Education and Training Committee shall 
recommend to the full Commission at its next 
regularly scheduled meeting the a pproval or 
denial of accreditation for the applicant institu- 
tion or agency. 

(d) Accreditation of a school shall remain effective for 
five years from issuance unless earlier suspended or revoked 
for just cause. 

(e)(b) The identity of those schools accredited under this 
Rule shall be published and distributed annually by the 
Standards Division together with the name and business 
address of the school director and the schedule of criminal 



justice training courses planned for delivery during the 
succeeding year. 

(f) A school may apply for reaccreditation to the Com- 
mission by submitting a properly completed Request for 
School Accreditation application. The a pplication for 
reaccreditation shall contain information on major changes 
in facilities, equipment, and staffing. Upon receipt of a 
properly completed application; 

(1) The Standards Division staff shall review the 
a pplication for any omissions and clarification; 

(2) Copies of the site visits conducted during the last 
period of certification shall be attached to the 
a pplication; 

(3) The application and staff reports shall be submit- 
ted to the Accreditation Committee for review; 

(4) A recommendation shall be submitted to the 
Education and Training Committee on the ap- 
proval or denial of the a pplication: 

(5) The Education and Training Committee shall 
recommend to the full Commission at its next 
regularly scheduled meeting the a pproval or 
denial of accreditation of the a ppi'cant institution 
or agency. 

(g) In instances where accredited schools have been found 
to be in compliance with 1_2 NCAC 9B .0200 through 
favorable site visit reports. Standards Division staff shall be 
authorized to reaccredit on behalf of the Commission. Such 
action shall be reported to the Commission through the 
Accreditation Committee and the Education and Training 
Committee at its next scheduled meeting. 

£h}(d) The Commission may suspend or revoke a school's 
accreditation when it finds that the school has failed to meet 
or continuously maintain any requirement, standard, or 
procedure for school or course accreditation. 

Statutory Authority G.S. 17C-6. 



SECTION .0600 - EQUIPMENT AND PROCEDURES 

.0601 APPROVED SPEED-MEASURING INSTRUMENTS 

(a-) — Th e following ppeed moaouring inotrum e nto ar e approv e d for radio miorowav e (radar) uoo, provided they or e not 
equipped with dual antenn as^- 






(43)- 



rep e al e d 
r e p e al e d 



(3) repeal od 

(4) repealed 

(#} rep e al e d 

(6) rep e al e d 

(7) repealed 

(8) repeal od 

(9} r e p e al e d 

(40) r e p e al e d 

(44) repealed 



Kustom HR 8 



Kuotom HR 12 



Stationary 
Moving/Stationary 



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10:2 



PROPOSED RULES 



(44) ropoalod 

(45) repeal e d 



(464- 






&&- 






Kuotom KR 1 1 



MPH K IS 



MPH K 55 



MPH S 80 



(494- 

(30) repeal e d 

(34) repeal e d 



Dooatur Ra Gun (RAS & "N" Series) 



(35) repeal e d 



Dooatur Ra Gun 1 and 3 (RAS) (Inoludod in No. 33) 
Kustom KR 10 SP 



(344- 
(354- 

(36) ropoalod 

(3?) repeal e d 

(3*4- 



Kuotom Faloon 



(39) Kustom Roadrunnor 

(30) Kustom Trooper 

Dooatur MVR 715 



Dooatur MVR 731 
Dooatur Hunter 



@3) 

(34) Kustom PRO 1000 

(35) MPH K15 H (86) 

(36) Appli e d Cono e pto Stalk e r 

(3?) Dooatur Gonooio 



Moving/Stationary 
Stationary 
Moving/Stationary 
Moving/Stationary 



Stationary 



Moving/Stationary 



Stationary 

Stationary 

Moving/Stationary 

Moving/Stationary 

Moving/Stationary 

Moving/Stationary 

Moving/ S tationary 

Stationary 

Moving/Stationary 

Moving/Stationary 



(a) The following speed-measuring instruments are approved for radio microwave (RADAR) use, provided they 
operated with a single antenna: 

Model Mode 



are 





Manufacturer 


ill 


Kustom Signals, Inc. 


(2) 


Kustom Signals, Inc. 


01 


Kustom Signals. Inc. 


(4} 


MPH Industries, Inc. 


{5} 


MPH Industries, Inc. 


m 


MPH Industries, Inc. 


hi 


Decatur Electronics, Inc. 


m 


Kustom Signals, Inc. 


£9} 


Kustom Signals. Inc. 


(10) 


Kustom Signals, Inc. 


0JQ 


Kustom Signals, Inc. 


(12) 


Decatur Electronics, Inc. 


(13) 


Decatur Electronics, Inc. 


(14) 


Kustom Signals, Inc. 


(15) 


MPH Industries. Inc. 


(16) 


Applied Concepts, Inc. 


(17) 


Decatur Electronics, Inc. 


(18) 


Applied Concepts. Inc. 


(19) 


Applied Concepts, Inc. 


(20) 


Applied Concepts, Inc. 


(21) 


Kustom Signals, Inc. 


(22) 


Kustom Signals, Inc. 


(23) 


Kustom Signals, Inc. 


(24) 


Kustom Signals, Inc. 


(25) 


M.P.H. Industries, Inc. 



HR-8 

HR-12 

KR-11 

K-15 

K-55 

S-80 

Ra-Gun 

KR-10 SP 

Falcon 

Roadrunner 

Trooper 

MVR 

Hunter 

Pro- 1000 

K-15 H 

Stalker ATR 

Genesis I 

Stalker ATR 

Stalker DUAL 

Stalker DUAL SL 

Eagle 

Eagle; Plus 

Eagle; Silver 

Eagle; Golden 

BEE-36 



Stationary 

Moving/Stationary 

Moving/Stationary 

Stationary 

Moving/Stationary 

Moving/Stationary 

Stationary 

Moving/Stationary 

Stationary 

Stationary 

Moving/Stationary 

Moving/Stationary 

Moving/Stationary 

Moving/Stationary 

Stationary 

Moving/Stationary 

Moving/Stationary 

Stationary 

Moving/Stationary 

Moving/Stationary 

Moving/Stationary 

Moving/Stationary 

Moving/Stationary 

Moving/Stationary 

Moving/Stationary 



(b) The following spood measuring instruments are approved for time distance use provided that the instrument i s not capable 
of aooopting doublo time or doublo distance into the computer! 



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138 



PROPOSED RULES 



ft) ropoalod 

(2) rep e al e d 

£J) repeal e d 

(4) ropoalod 

(5) Vascar Plus 



Troffio Safety Syotomo, he- 



rb) The following speed-measuring instruments are a pproved for time-distance use: 
Manufacturer Model 



Mode 



(1) Traffic Safety Systems, Inc. 



VASCAR-plus 



Moving/Stationary 



(c) All approved models and types of radio microwave (radar) speed-measuring instruments are made subject to and 
restricted as follows: 

(1) The automatic operate functions have been disconnected. 

(2) The automatic alarms, audio and visual have been disconnected. 

(3) The automatic locking functions have been disconnected. 

(4) The instrument does not provide an external control that would permit the adjustment or correction of the zero 
or calibration readings. 

(5) The "High Speed Lock" function has been disconnected. 

Note: The automatic functions that shall be disconnected are any and all automatic violation alarm or lock 
capabilities that occur prior to the speed measuring instrument being manually locked by the operator. 

(d) All radar speed measuring instruments, as herein defined, purchased on or after July 1, 1982 for speed enforcement 
shall meet or exceed performance specifications as provided in the "Model Performance Specifications for Police Traffic 
Radar Devices" as prepared by the Law Enforcement Standards Laboratory of the National Bureau of Standards and 
published by the National Highway Traffic Safety Administration, United States Department of Transportation (as in effect 
July 1, 1982) incorporated by reference herein and including any later amendments and editions as provided for in G.S. 
150B-21.6. Copies of the document in this Rule are available from the agency address at the cost of three dollars and 
seventy-five cents ($3.75) per copy. 

(e) Prior to inclusion as an approved radar speed measuring instrument, the manufacturer of said instrument shall certify 
in writing to the agency that said instrument meets or exceeds the standards of 12 NCAC 9C .0601(d) and provide a copy 
of a testing report or other document illustrating the method and results used in such certification. 

Statutory Authority G. S. 1 7C-6. 

SUBCHAPTER 9D - PROFESSIONAL 
CERTIFICATE PROGRAMS 

SECTION .0100 - LAW ENFORCEMENT 
OFFICERS' PROFESSIONAL CERTIFICATE £4} 

.0102 GENERAL PROVISIONS 

(a) In order to be eligible for one or more of the profes- 
sional awards, an officer shall first meet the following 
preliminary qualifications , oxoopt as provided for in 12 
NCAC 9D ■0102(a)('1) : 

(1) The officer shall presently hold general law 
enforcement officer certification. A person 
serving under a probationary certification is not 
eligible for consideration. 

(2) The officer shall be familiar with and subscribe 
to the Law Enforcement Code of Ethics. 

(3) The officer shall be a full-time, sworn, paid 
member of a law enforcement agency within the (5) 
state. 

(4) Applicants who booamo full timo, sworn, paid 

members of a law enforcement agoncy prior to 



October 1, — 19 84 , shall bo evaluated under 
criteria in existence on April 30, 19 86 . — : ¥h&% 
oriteria shall be appli e d for a p e riod of tim e not 
to exceed Deoomb e r 31, 1990. 
(5)Effootivo May 1, 19 8 6, all All applicants who 
become became full-time, sworn, paid members 
of a law enforcement agency within the state on 
or after October 1, 1984, shall be given credit 
for satisfactory completion of only one commis- 
sion-accredited basic training program for pur- 
poses of calculating training points. Furth e r 
mor e , in addition to mooting the qualifications 
sot forth in this Rule, those applicants shall also 
have acquired the combination of educational 
points or degrees, — law enforcement training 
points and y e ars of full tim e law e nforc e m e nt 
experience — as — outlined — » — Rules — .0103, 
■010 4 (a)(2), or .0105(a)(2) of this Section. 
(6) Full-time, paid employees of a law enforce- 
ment agency within the State who have success- 
fully completed a commission-accredited law 
enforcement officer basic training program and 



139 



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10:2 



PROPOSED RULES 



have previously held general law enforcement 
officer certification as specified in 12 NCAC 9D 
.0102(a)(1), but are presently, by virtue of 
promotion or transfer, serving in non sworn 
positions not subject to certification are eligible 
to participate in the professional certificate 
program. Eligibility for this exception requires 
continuous employment with the law enforce- 
ment agency from the date of promotion or 
transfer from a sworn, certified position to the 
date of application for a professional certificate. 

(b) Awards are based upon a formula which combines 
formal education, law enforcement training, and actual 
experience as a law enforcement officer. Points are 
computed in the following manner: 

(1) Each semester hour of college credit shall equal 
one point and each quarter hour shall equal 
two-thirds of a point; 

(2) Twenty classroom hours of commis- 
sion-approved law enforcement training shall 
equal one point; 

(3) Only experience as a full-time, sworn, paid 
member of a law enforcement agency or equiva- 
lent experience shall be acceptable for consider- 
ation. 

(c) Certificates will be awarded in an officer's area of 
expertise only. Separate sub-programs will be administered 
as follows: 

(1) General Law Enforcement Certificate. The 
General Law Enforcement Certificate is appro- 
priate for full-time, sworn law enforcement 
officers employed by units of local government 
with authority to arrest for any violation of the 
criminal law and to arrest anywhere within the 
boundaries of the unit, including: 

(A) municipal and county police officers, 

(B) local ABC board enforcement officers. 



(2) State Law Enforcement Certificate. The State 
Law Enforcement Certificate is appropriate for 
full-time, sworn law enforcement officers em- 
ployed by an agency of state government, with 
authority to arrest throughout the state, includ- 
ing: 

(A) Special agents of the State Bureau of Investiga- 
tion, 

(B) State Highway Patrol officers, 

(C) State Alcohol Law Enforcement officers, 

(D) lioono e and th e ft Division of Motor Vehicles 
officers, 

(E) Fisheries enforcement officers, 

(F) Wildlife enforcement officers, and 

(G) State forest rangers. 

(3) Special Law Enforcement Certificate. The 
Special Law Enforcement Certificate is appropri- 
ate for other full-time, sworn law enforcement 
officers with arrest authority, including: 

(A) Security officers for State buildings and agen- 
cies, 

(B) Airport security officers, 

(C) Campus police officers, 

(D) Company police officers, 

(E) Department of Correction extradition officers, 
and 

(F) Parks and recreation commissions enforcement 
officers. 

(d) There shall be limited reciprocity between 
sub-programs. Only training and/or experience gained in an 
officer's area of expertise will be eligible for application to 
the sub-program. 

Statutory Authority G.S. 17C-6. 



.0104 INTERMEDIATE LAW ENFORCEMENT CERTIFICATE 

(a) In addition to the qualifications set forth in Rule .0102(a) of this Subchapter, an applicant for the Intermediate Law 
Enforcement Certificate shall possess or be eligible to possess the Basic Law Enforcement Certificate and shall have acquired 
the following combination of educational points or degrees, law enforcement training points and years of full-time law 
enforcement experience: 

(4) The following standard will bo applied in evaluating applicants pursuant to Rule .0102(a)( 4 ) of this Section: 



Eduoational Dogrooo 



AA/AS 



AB/BS 



Years of Law 
Enforcement Experience 



Minimum Law 
Enforcement Training 
Points 



45- 



44 



Minimum Total 
Education and Training 
Points 



-30- 



-60- 



-90- 



45- 



44 



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April 17, 1995 



140 



PROPOSED RULES 



(2) The following standard will bo applied in evaluating applicants pursuant to Rule .0102(a)(5) of this Section: 

Educational Degrees AA/AS AB/BS 



Years of Law 
Enforcement Experience 

Minimum Law 
Enforcement Training 
Points 



8 



22 



21 



Minimum Total 
Education and Training 
Points 



37 



67 



97 



22 



21 



(b) Educational points claimed shall have been earned at a technical institute, technical college, community college, junior 
college, college or university accredited as such by the Department of Education of the state in which the institution is 
located, the appropriate recognized accrediting body, or the state university of the state in which the institution is located. 

Statutory Authority G.S. 17C-6. 

.0105 ADVANCED LAW ENFORCEMENT CERTIFICATE 

(a) In addition to the qualifications set forth in Rule .0102(a) of this Subchapter, an applicant for the Advanced Law 
Enforcement Certificate shall possess or be eligible to possess the Intermediate Law Enforcement Certificate and shall have 
acquired the following combination of educational points or degrees, law enforcement training points and years of full-time 
law enforcement experience: 

ft) The following standard will be appli e d in e valuating applicants purouant to Rul e .0201(a)Cl) of this S e ction: 



Educational Degrees 



Y e ars of Law 
Enforcement Experience 



Minimum Law 
Enforc e m e nt Training 
Points 



42- 



AAMS 



AB/BS 



GRAD./PRO . 



-34- 



48- 



44 



Minimum Total 
Educat i on and Training 
Points 



-60- 



-90- 



-24- 



48- 



44 



(3) Th e following standard will b e appli e d in evaluating applicants purouant to Rul e .0102(a)(5) of this S e otion: 



Educational Degrees 

Years of Law 
Enforcement Experience 

Minimum Law 
Enforcement Training 
Points 



12 



AA/AS 



31 



AB/BS 



25 



GRAD./PRO. 



21 



Minimum Total 
Education and Training 
Points 



67 



97 



31 



25 



21 



(b) Educational points claimed shall have been earned at a technical institute, technical college, community college, junior 
college, college or university accredited as such by the Department of Education of the state in which the institution is 



141 



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10.2 



PROPOSED RULES 



located, the recognized national accrediting body, or the state university of the state in which the institution is located. 



Statutory Authority G.S. 17C-6. 

.0106 METHOD OF APPLICATION 

(a) All applicants for an award of the basic, intermediate 
or advanced certificates in each sub-program shall complete 
an "Application for Award of Law Enforcement Certifi- 
cate. " 

(b) Documentation of education and training shall be 
provided by certified copies of transcripts, diplomas, Report 
of Training Course Completion, agency training records, or 
other verifying documents attached to the application. 

(c) The applicant shall submit the Application for Award 
of Law Enforcement Certificate to his the department head 
who shall attach hw a recommendation and forward the 
application to the Commission. Certificates will be issued 
to the ©department head for award to the applicant. 

(d) Certificates and awards remain the property of the 
Commission and the Commission shall have the power to 
cancel or recall any certificate or award. 

Statutory Authority G.S. 17C-6. 



TITLE 13 



DEPARTMENT OF 
LABOR 



Notice is hereby given in accordance with G.S. 
150B-21.2 that the North Carolina Department of 
Labor intends to amend rules cited as 13 NCAC 12 .0101, 
.0303, .0307 -.0309, .0501; adopt 12 .0304 - .0306, .0310 
- .0315, .0803 - .0808; and repeal 12 .0502. 

Proposed Effective Date: August 1, 1995. 

A Public Hearing will be conducted at 10:00 a.m. on 
Friday, June 2, 1995 at the Agriculture Building, Room 359, 
2 W. Edenton Street, Raleigh, NC 27601. 

Reason for Proposed Action: To update the Wage and 
Hour regulations. As part of the process of revising these 
rules, the Department proposes a rearrangement of the rule 
numbers in certain sections. This proposal is made for 
purposes of clarifying the rules. 

Comment Procedures: Please submit your comments to Mr. 
Scott Templeton, APA Coordinator, NC Department of 
Labor, 4 W. Edenton Street, Raleigh, NC 27601, FAX: 
(919) 715-5629; telephone: (919) 733-0368 by June 2, 1995. 
You may present written or oral comments at the hearing; 
however, time limits may be imposed by the chair. 

Fiscal Note: These Rules do not affect the expenditures or 
revenues of local government or state funds. 



CHAPTER 12 - WAGE AND HOUR 
SECTION .0100 - GENERAL PROVISIONS 

.0101 WAGE AND HOUR DIVISION 

The main office of the Wage and Hour Division, which 

administers the provisions of Article 2A of G.S. Chapter 95, 

is maintained in the Raloigh office of the Department of 

Labor at 4 West Edenton Street, 413 N. Salisbury Street. 

Raleigh, North Carolina 27601 27603 . The Division 

maintains a branch offio e o office at 20 South Spruc e Street, 

Ashovillo, — North — Carolina; — 1-+5 — Broad foot — Avenue, 

Fayottovillo, North Carolina; and 500 West Trade Street, 

Charlotte, North Carolina where it also receives public 

inquiries and complaints. Other field offices are maintained 

throughout the state where meetings may be arrang ed by 

appointment. The Division's mailing address is: 

Wage and Hour Division 

North Carolina Department of Labor 

4 West Edenton Street 413 N. Salisbury St. 

Raleigh, North Carolina 27601 27603 

919/733-2152. 

Statutory Authority G.S. 95-25.17. 

SECTION .0300 - WAGES 

.0303 CERTIFICATION OF TffS 

(a) For the purpose of counting tips as wages pursuant to 
G.S. 95-25. 3(f), acceptance of wages from the employer 
does not constitute certification by the employee of tips 
received. 

(b) An employer must maintain accurate and complete 
records of each employee's tips, whether received individu- 
ally or as part of a tip pooling arrangement. Individual 
contributions and resulting shares of any tip pooling must 
shall be recorded. In addition, an employer's records mast 
shall show the amount claimed as a tip credit for each 
employee for each workweek. If the amount claimed as a 
credit cannot be calculated from the records for any work- 
week, the employer «ay- shall not count the tips as wages. 

(c) If an employer maintains the required records of each 
employee's tips, obtaining the signature or initials of the 
employees monthly or for each pay period constitutes 
certification by the employees and these tips wiH shall be 
counted as wages pursuant to G.S. 95-25. 3(f). 

(d) This Section applies only to tipped employees who do 
not participate in a ti p pooling arrangement. If the tipped 
employee refuses to certify tips accurately and completely, 
tips may still be counted as wages when the employer 
complies with the provisions of G.S. 95-25. 3(f) and can 
demonstrate by showing timely written documentation that 
a tipped employee regularly receives tips in the amount for 



10:2 



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April 17, 1995 



142 



PROPOSED RULES 



which the tip credit is taken. While no particular form of 
written documentation is required, it is sufficient for a 
tipped employee to certify tips in the amount for which the 
tip credit is taken or for the employer to show that a tipped 
employee similarly situated certifies that he or she regularly 
receives tips in the amount for which the tip credit was 
taken. Such certification shall be made each pay period or 
month. 

(e) If tipped employees are participating in a tip. pooling 
arrangement, the employer is required under all circum- 
stances to keep accurate and complete records of tips 
received by each employee participating in the tip pooling 
arrangement. 

Statutory Authority G.S. 95-25.3; 95-15; 95-19. 

.0304 EMPLOYER ADDED SERVICE CHARGES 
AND GRATUITIES 

(a) Service charges included by the employer in the 
charge to the customer constitute amounts due the business 
and are not tips within the meaning of the term as defined 
in G.S. 95-25.2(15). An employer's retention of all or part 
of such a service charge shall not, unless otherwise prom- 
ised, violate the requirement of G.S. 95-25.6 to pay all 
wages and tips accruing to the employee, nor shall such 
retention invalidate an otherwise valid tip credit arrange- 
ment. 

(b) A gratuity added by the employer to the charge to the 
customer is a tip, which, absent an agreement to the 
contrary, belongs the employee. 

Statutory Authority G.S. 95-25.2(15); 95-25.6; 95-25.19. 

.0305 TIPS CHARGED ON CREDIT CARDS 

(a) Where tips are charged on credit cards, employers 
may retain from the tips an amount up to or equal to the pro 
rata portion of the fee charged by the credit card company 
that is attributable to the tips. When employers make such 
retentions, they do so without violating G.S. 95-25.6 and 
without becoming disqualified from claiming the tip credit 
on the charged tip because the tipped employee has not been 
allowed to retain all tips pursuant to G.S. 95-25.3(f). 

(b) Where tips are part of the employee's compensation, 
tips charged on credit or charge cards accrue to the em- 
ployee at the time they are charged and shall be paid on or 
before the payday of the pay period in which they are 
charged. 

Statutory Authority G.S. 95-25.3; 95-25.6; 95-25.19. 

.0306 TIP POOLING 

(a) In a ti p pooling arrangement, for the purposes of G.S. 
95-25.6 'tips accruing to the employee" shall mean either 
the employee's share of the tip pool or 85% of the em- 
ployee's tips before they were pooled, whichever is greater. 

(b) When an employer allows a tipped employee, who is 
participating in a tig pooling arrangement, to retain the 
amount specified in Paragraph (a) of this Rule, the employer 



has satisfied the provision under G.S. 95-25.3(0 requiring 
the employer to allow the tipped employee to retain all tips. 

(c) An employer shall give each employee who is re- 
quired to participate in a tip pooling arrangement advance 
notice of the arrangement in accordance with G.S. 95-25.13. 
Employees not so notified are not subject to the tin. pooling 
arrangement, unless they otherwise agree to iL 

(d) Only those employees who are employed in occupa- 
tions that customarily and regularly receive tips may share 
in a tirj pooling arrangement. Examples of such occupations 
include waiters, waitresses, bellhops, busboys/girls. and 
bartenders. Examples of occupations that shall not partici- 
pate in tip pooling arrangements include janitors, dishwash- 
ers, chefs and cooks. 

Statutory Authority G.S. 95-25. 3(f); 95-25.6; 95-25.13; 95- 
25. 19. 

.0307 t«3«5 AUTHORIZATION FOR WITHHOLDING 
OF WAGES 

(a) An authorization by an employee which will allow the 
employer to withhold or divert a portion of an employee's 
wages must shall be in writing and must specify the reason 
for the deduction. 

(b) An authorization for withholding of wages must shall 
be signed on or before the payday for the pay period from 
which the deduction is to be made. The two permissible 
types of authorization are the specific authorization and the 
blanket authorization. 

(c) A specific authorization may be for one or more 
paychecks and muot shall state the dollar amount or percent- 
age of wages which the employee agrees may be deducted 
from each paycheck. Employees must shall be given a 
reasonable opportunity to withdraw specific authorizations 
if such deductions are for their convenience. Deductions for 
the convenience of the employees may include, but are not 
limited to, such things as insurance, savings plans, credit 
union installments, savings bonds, union or club dues, 
uniform rental, uniform cleaning, parking and charitable 
contributions. All othor authorizntiona for withholding o f 
specific amounts, onoo agreed upon by an employee, may 
not be withdrawn. A payroll deduction that satisfies a 
requirement of the employer is not a deduction for the 
convenience of the employee within the meaning of G.S. 95- 
25.8(2). and the employer is not required to give employees 
a reasonable opportunity to withdraw their authorization 
prior to making such a deduction. 

(d) A blanket authorization may be signed by an em- 
ployee which authorizes specific categories of deductions or 
withholdings without specifying an actual dollar amount. 
When the amount of any such deduction becomes known, 
the employer m&f shall not make the deduction until the 
employee has been given advance notice of the specific 
amount of the proposed deduction and has been given a 
reasonable opportunity to withdraw h+s authorization before 
the deduction is made. What constitutes advance notice for 
deductions involving cash shortages, inventory shortages, or 
loss or damage to an employer's property is at least the 



♦ 



143 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



seven day period prescribed in G.S. 95-25.9 and Rule .0304 
of this Section. 

(e) Specific and blanket authorizations signed by an 
employee aaay shall not waive and must shall comply with 
the authorization requirements, monetary limitations and 
time requirements specified in G.S. 95-25.8, 95-25.9 and 
95-25.10 of the Wage and Hour Act, and the rules and 
regulations promulgated thereunder. 

(f) G.S. 95-25.8(2) requires the employer under certain 
circumstances to give the employee a reasonable o pportunity 
to withdraw the employee's authorization. In determining 
whether the employee was in fact given a "reasonable 
o pportunity", such factors as the amount of time between 
when the employee was given advance notice of the em- 
plover's intent to deduct under the authorization, the time of 
the deduction, and the accessibility to the employee of the 
person designated to receive such withdrawals shall be 
considered, but under no circumstances shall an employee 
be found to have been given a reasonable o pportunity to 
withdraw the authorization if the employee did not have 
knowledge of the right to withdraw. While not required, 
the inclusion of a notice of the right to withdraw in the 
authorization signed by the employee shall be presumptive 
evidence that the employee had knowledge of that right. 

(g) The taking of a wage credit for an advancement of 
wa ges does not fall within the scope of G.S. 95-25.8(2). and 
no written authorization is required prior to crediting the 
advancement toward wages due. 

(h) An employee's authorization in accordance with G.S. 
95-25.8(2) to allow an employer to withhold or divert a 
portion of the employee's wages shall be invalid if the 
reason for the deduction or withholding is illegal. For 
example. G.S. 97-21 invalidates agreements by an employee 
to pay any portion of a premium paid by his or her em- 
ployer to a workers' compensation insurance carrier, and 13 
NCAC 7F.0101(a) requires the employer to provide, at no 
cost to the employee, all personal protective equipment 
which the employee does not wear off the jobsite for use off 
the job. If an employer withholds or diverts wages for 
either of these reasons, even if the employee authorizes the 
withholding in writing pursuant to G.S. 95-25.8(2). the 
employer shall be in violation of G.S. 95-25.6 or G.S. 95- 
25.7. or both, because that authorization is invalid. 

ill If the employer obtains written authorization pursuant 
to G.S. 95-25 .8(2)(a) to withhold a specific amount or 
percentage from a series of paychecks to recover an amount 
other than an advance owed to the employer and includes in 
the authorization a provision for deducting the balance of the 
unpaid amount from the employee's paycheck in the event 
the employee separates before the full amount has been 
collected, the employer may deduct as much of the balance 
possible from the final paycheck without having to give the 
employee notice of the amount and a reasonable opportunity 
to withdraw his or her authorization as required by G.S. 95- 
25.8(2)(b). subject to the withholding limitations of G.S. 95- 
25.10. If the employer does not include in the specific 
authorization an express provision to deduct the balance 



upon an employee's separation, then an employer shall not 
deduct from the final paycheck an unpaid balance which is 
greater than the specific amount or percentage authorized 
unless an additional authorization is obtained. 

(i) Where tips or the reasonable costs of furnishing 
employees with meals, lodging or other facilities are 
credited as wages paid to an employee pursuant to the 
provisions of Chapter 95. Article 2A and this Chapter, the 
employer is not required to obtain prior written authoriza- 
tion pursuant to G.S. 95-25.8(2) since a wage credit is not 
a withholding of wages. 

(k) An employer shall comply with G.S. 95-25.8(2) 
before making a deduction from an escrow or bond account 
funded by wages and established for the purpose of recover- 
ing amounts owed to the employer. 

Statutory Authority G.S. 95-25.8; 95-25.9; 95-25.10; 95- 
25.11; 95-25.13, 95-25.19. 

.0308 ,03018 VACATION PAY 

(a) The purposes of the vacation provisions of the Wage 
and Hour Act are to ensure that employees know what their 
vacation benefits are and that they receive the promised 
benefits. Employees mu n i shall be notified of company the 
employer's policies and practices concerning vacation pay 
in two ways. Pursuant to G.S. 95-25.13(1), an e mploy ee 
employees must shall initially be notified orally or in writing 
at the time of hiring. Pursuant to G.S. 95-25.13(2), an 
employee employees must shall ake subsequently be notified 
by making a copy of the policies and practices available to 
them in writing or through a posted notice maintained in a 
place accessible to the employee employees . All vacation 
policies and practices communicated to employees must shall 
address: the method of vacation calculation so that the 
employees know e mploy ee knows the number of days of 
vacation to which he is they are entitled; whether or not 
vacation days may be carried forward from one year to 
another; when vacation days must be taken; when and if 
vacation pay may be paid in lieu of time off; and, under 
what conditions and in what amount vacation pay will be 
paid upon termination. Ambiguous policies and practices 
will shall be construed against the employer and in favor of 
the employees. 

(b) If a company providoo vacations, all vacation time or 
payment in liou of time off mu s t bo paid to the employee s 
in aooordanoe with e stablish e d company policy or past 
praotio e as known and und e rstood by the employees. 

£b)(e) Any employer who fails to notify an employee in 
accordance with G.S. 95-25.13 and Paragraph (a) of this 
Rule, of any policy or practice which requires or results in 
a loss or forfeiture of vacation time or pay, is liable for 
such vacation time and pay without loss or forfeiture by the 
employee. 

Statutory Authority G.S. 95-25.12; 95-25.13; 95-25.19. 

.0309 t0307 BONUSES AND COMMISSIONS 



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(a) Payment of wages based on bonuses, commissions or 
other forms of calculation may be paid as infrequently as 
annually, so long as employees are notified in advance of 
earning such wages of the employer's time for payment of 
such wages. Employees must shall also be notified in 
accordance with the provisions of G.S. 95-25.13 of any 
oompany policy or practice which requires or results in 
forfeiture of such wages. 

(b) Employees must shall be notified of the time for 
payment and of forfeiture policies relating to wages based 
on bonuses, commissions or other forms of calculation in 
two ways. Pursuant to G.S. 95-25.13(1), an omployoo 
employees must shall initially be notified orally or in writing 
at the time of hiring. Pursuant to G.S. 95-25.13(2), a« 
employe e employees must shall subsequently also be notified 
by making a copy of the policies and practices available to 
them in writing or through a posted notice maintained in a 
place accessible to the employ ee employees . 

(c) Any employer who fails to notify an employee in 
accordance with G.S. 95-25.13, and Paragraphs (a) and (b) 
of this Rule, is liable for such wages based on bonuses, 
commission or other forms of calculation without forfeiture 
by the employee. 

Statutory Authority G.S. 95-25.6; 95-25.7; 95-25.13; 95- 
25.19. 

.0310 FINAL PAY 

(a) For the purposes of determining pursuant to G.S. 95- 
25.7 the payday on which separated employees shall be paid 
all wages due, the "next regular payday* is that payday for 
the pay period during which the employee separates from 
employment or. in the case of commissions, bonuses and 
other forms of calculation, the first regular payday is that 
payday for the pay period during which such wages become 
calculable. 

(b) G.S. 95-25.7 requires the employer to mail the final 
paycheck to the employee at its own expense if requested by 
the employee. Employers shall not withhold the final 
paycheck because the employee refuses to come to the 
business office or place of employment to pick up the 
paycheck if the employee requests the employer to mail it to 
him/her in accordance with G.S. 95-25.7. The employer 
may require the employee to provide a notarized or wit- 
nessed written request to avoid fraudulent requests. In all 
cases, the employee is owed the wages due until he/she 
receives his/her final paycheck. However, if the check is 
dishonored by the financial institution against which it is 
drawn, then the employer's obligation to pay the wages 
remains. 

(c) If an employee requests to receive the final paycheck 
by mail pursuant to G.S. 95-25.7. the employer shall not, 
without written authorization pursuant to G.S. 95-25.8. 
deduct any costs related to the replacement of a paycheck 
which is lost or stolen prior to the employee's receipt of the 
check. 

Statutory Authority G.S. 95-25.7; 95-25.8; 95-25.19. 



.0311 ADVANCEMENT OF WAGES 

(a) The requirement of G.S. 95-25.6 that the employer 
shall pay every employee all wages and tips accruing to the 
employee on the regular payday is met if the employer pays 
the accrued wages in advance of the regular payday. 

(b) Any form of wages advanced by an employer to an 
employee which have not been repaid by the employee may 
be used by the employer as a credit toward any other form 
of wages due the employee. For example, if an employer 
has advanced an employee two weeks' wa ges and the 
employee quits after working only one more week, the 
employer may credit the second week's advanced wages 
toward any vacation pay owed to the employee at separa- 
tion. 

(c) Amounts which an employer has advanced to an 
employee through a payment to a third party primarily for 
that employee's benefit and at the employee's request or 
with the employee's knowledge and consent may be credited 
toward wages owed to the employee without first obtaining 
the prior written authorization required by G.S. 95-25.8(2). 
For example, if an employer pays an employee's car loan 
payment at the employee's request, the employer may credit 
the amount paid on the employee's behalf as an advance 
toward the employee's accrued wages. A dated receipt 
evidencing the payment to the third party, signed by the 
employee, shall be sufficient to show that the advancement 
was requested or a pproved and made. 

Statutory Authority G.S. 95-25.2(16); 95-25.8; 95-25.19. 

.0312 LOANS FROM EMPLOYERS TO 
EMPLOYEES 

(a) In the absence of an executed loan document, the 
principal of a loan from an employer to an employee is an 
advance of wages. The loan shall be from the employer and 
not a personal loan merely from a supervisor or another 
employee. If the employer is a corporation, the loan shall 
have been made from corporate funds. If the employer is 
a sole proprietor or a partnership, a loan from the proprietor 
or any partner shall constitute a loan from the employer and 
may be treated as an advance of wages. 

(b) A loan includes credit advanced by the employer to an 
employee for purchasing from the employer items not 
primarily for the benefit of the employer. 

(c) A deduction for interest and other charges related to 
the loan shall only be withheld from the employee's wages 
with proper authorization under G.S. 95-24.8(2). 

(d) A loan from a third party, such as a bank or credit 
union, is not an advance of wages, and written authorization 
under G.S. 95 -25. 8 (2) shall be secured by the employer 
prior to deducting for such a loan. 

Statutory Authority G.S. 95-25.2(16); 95-25.8; 95-25.13; 
95-25. 19. 

.0313 MISCALCULATION OF WAGES 

(a) An overpayment to an employee as a result of a 
miscalculation of wages or other bona fide error may be 



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treated as an advance- 
da) When a miscalculation of wages or other bona fide 
error results in a payment of wages less than the actual 
wages accrued during the pay period, a violation of G.S. 
95-25,6 shall have occurred, and the employer shall pay the 
amount due as soon as possible upon the discovery of the 
error together with interest at the legal rate set forth in G.S. 
24-1 from the date the wages first became due. 

Statutory Authority G.S. 95-25.2(16); 95-25.6; 95-25.19. 

.0314 FORM OF PAYMENT OF WAGES 

Since G.S. 95-25.6 and G.S. 95-25.7 do not provide for 
a specific form of payment, the employer may select any 
legal form of payment, so long as payment is made in full 
on the designated payday, subject to authorized deductions 
and legal withholdings. Acceptable forms of payment 
include cash, money order, negotiable checks, and direct 
deposit into an institution whose deposits are insured by the 
United States government or an institution selected by the 
employee. 

Statutory Authority G.S. 95-25.6; 95-25.7; 95-25.19; 95- 
245. 

.0315 OTHER AMOUNTS PROMISED AS WAGES 

So long as the employer has promised to make such 
payments and has a policy or practice of making such 
payments, wages in the form of "other amounts promised" 
as that term is used in G.S. 95-25.2(16) include, but are not 
limited to such other forms of compensation as travel 
expenses, holiday pay, birthday pay, jury duty pay, shift 
premium pay, prizes such as trips if commission quota is 
met, moving expenses, educational expenses, telephone 
expenses, and other reimbursements so long as the employer 
has promised to make such payments and has a policy or 
practice of making such payments. 

Statutory Authority G.S. 95-25.2(16); 95-25.19. 

SECTION .0500 - JURISDICTION 
AND EXEMPTIONS 

.0501 EXEMPTIONS 

(a) The exemption from minimum wage, overtime, youth 
e mployment and recordkeeping, for any person covered by 
th e Fair Labor Standnrdo Aot, appli e o to p e roono whos e 
wages, ov e rtime, and conditions and reoordo of e mploym e nt 
are regulated by the Fair Labor Standards Act and the rule s 
promulgated thereunder. Persons covered by the Fair Labor 
Standards Aot, but whoo e wages, ov e rtim e , and conditions 
and rooords of e mploym e nt ar e e x e mpted from f e d e ral 
regulation, are subject to the state wage and hour provisions 
unless sp e cifically exempted by the Wage and Hour Act. 

(a) Subject to the specific exceptions stated in sub- 
subdivisions a^ b^ and c of G.S. 95-25. 14(a)(1). that sub- 
division exempts from minimum wage, overtime, and youth 



employment coverage of the Wage and Hour Act certain, 
but not all employees covered by the minimum wage, 
overtime, and youth employment provisions of the Fair 
Labor Standards Act. 29 USC §201 et seq (herein "FLSA"). 
Only those employees employed by an "enterprise engaged 
in commerce or the production of goods for commerce" as 
defined in 29 USC §203(s) are exempt from those provi- 
sions of the Wage and Hour Act. Employees who are 
covered by the FLSA by virtue of their involvement in 
interstate commerce, but who are not employed by an 
enterprise engaged in interstate commerce, are not exempt 
from the Wage and Hour Act provisions under this sub- 
division and are covered by both Acts. 

(b) For the purpose of clarifying the exemptions under 
G.S. 95-25. 14(a)(1)(c) of the Wage and Hour Act, where 
the FLSA provides an exemption from minimum wage, 
overtime or child labor to an employee in a FLSA covered 
enterprise and the Wage and Hour Act does not contain the 
same exemption, the employees and employers so exempted 
by the FLSA shall be covered under the North Carolina 
Act. The following are some examples of FLSA covered 
enterprises whose employees, exempted from FLSA provi- 
sions, continue to have full minimum wage and overtime 
coverage under G.S. 95-25.3 and G.S. 95-25.4 of the Wage 
and Hour Act due to the FLSA exemption noted: 

(1) Seasonal amusement or recreational establish- 
ments as exempted under 29 USC 8213(a)(3). 

(2) Small newspapers as exempted under 29 USC 
§2 13(a)(8). 

(3) Small public telephone companies as exempted 
under 29 USC §213(a)(10). 

(c) Where the FLSA provides exemptions from its 
overtime requirements to certain FLSA covered employees 
or employers and the Wage and Hour Act does not contain 
the same exemption, such FLSA exempted employees and 
employers shall be covered under the North Carolina Act. 
The following are some examples of such employees and 
employers: 

(1) Outside buyers of poultry, eggs, and milk as 
exempted under 29 USC §213(b)(5). 

(2) Small grain elevators as exempted under 29 USC 
§213(b)(14). 

(3) Maple sugar or syrup processors as exempted 
under 29 USC §213(b)(15). 

(4) Employees engaged in intra-state transportation 
of fruits or vegetables as exempted under 29 
USC §213(b)(16). 

(5) Motion picture theaters as exempted under 29 
USC §213(b)(27). 

(6) Small lumbering or forestry operations as ex- 
empted under 29 USC §213(b)(28). 

(7) Newspaper carriers and makers of wreaths 
composed of natural materials as exempted 
under 29 USC §213(d). 

(d) Where the FLSA contains an overtime exemption 
which provides a method for calculating overtime in the 
alternative to the normal time and one-half the regular rate 



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of pay for hours worked in excess of 40 in a workweek, and 
the North Carolina Wage and Hour Act does not contain 
such exemptions, the Wage and Hour Act adopts by refer- 
ence the FLSA exemption with the alternate overtime 
calculation methods and applies those methods to similar 
state-covered businesses. The following are examples of 
FLSA overtime exemptions which provide for an alternate 
method for calculating overtime and which are adopted by 
reference under G.S. 95-24. 14(a)(1)(c): 

£1) 29 USC 5207(b)(3) which exempts employees of 
certain petroleum distributors. 

(2) 29 USC 8207(f) which exempts certain employ- 
ees who work irregular hours and are paid a 
guaranteed salary. 

(3) 29 USC 5207(g) which exempts certain piece 
rate workers. 

(4) 29 USC §207(0 which exempts certain commis- 
sioned inside salespersons in retail. 

(5) 29 USC §207(j) which exempts certain employ- 
ees of hospitals, nursing homes, old age homes. 

(6) 29 USC §207(m) which exempts certain seasonal 
employees at tobacco warehouses and auctions. 

£7) 29 USC 8207(n) which exempts certain bus 
drivers. 

£8) 29 USC §213(b)29 which exempts certain em- 
ployees of concessionaires in national parks. 

£9} 29 USC §2 13(h) which exempts certain seasonal 
employees in cotton pinning, sugarcane or 
sugarbeet processing. 

(10) 29 USC §213(i) which exempts certain seasonal 
employees in local cotton ginning. 

(11) 29 USC §213(j) of the FLSA which exempts 
certain seasonal employees in sugar processing. 

(e)fb> The statutory exemption from certain wage and 
hour provisions for the spouse, child, parent or dependent 
of the employer applies equally to the spouse, child, parent 
or dependent of corporate officers. For the purposes of this 
Section only, corporate officers are those who dir e ctly h e ad 
control the day to day affairs of the establishment and: 

(1) are majority stockholders, or 

(2) are principal stockholders with voting control, or 

(3) are in voting control through stock ownership or 
with joint ownership of spouse or family. 

£f}(e) Homes for dependent children pursuant to G.S. 
95-25. 14(c)(6) include institutions and group homes for 
dependent children. 

Statutory Authority G.S. 95-25.14; 95-25.19. 

.0502 COUNTING EMPLOYEES 

(ft) — For th e purpos e of e stablishing jurisdiction pursuant 
to G.S. 95 25.1 4 (bX5), a proprietor or ownor who works in 
and about hi s enterpri s e is not counted as a person employed 
in th e e nt e rpris e . 

(b) With r e opeot to a businooo sot up as a oorporation, if 
an office r of the corporation only performs dut i es of an 
executive nature, ho will not be oounted as an employee. 
How e ver, — if an offioor porforms manag e rial — or oth e r 



non executive duties, he is an employee of the oorporation 
and will b e oount e d for jurisdictional purpos e s. 

fe-) — With r e opoot to partnership s , a partn e r who has a 
substantial ownership interest and functions as a proprietor 
or ownor will bo treated as an employer. Whore the partner 
ship inter e st and inoid e no e of ownership authority ar e d e 
minimis, a partn e r will b e oounted as an e mploye e^ 

(d) Part time employees and family members who work 
in an enterprise will be oounted in determining the numbe r 
of persons employed for jurisd i ctional purposes. 

( e ) Th e numb e r of e mployoos at an e nterpris e who work 
during the oourso of a workwook, not the number of 
employees working on any particular day, determines the 
wag e and hour jurisdiction for any workw ee k. 

Statutory Authority G.S. 95-25.14; 95-25.19. 

SECTION .0800 - RECORDKEEPING 

.0803 SCOPE OF PROMISED WAGES 

For the purposes of G.S. 95-25.13, the term "promised 
wages" includes all forms of wages as defused in G.S. 95- 
25.2(16). and any policy or practice with re gard to such 
wages. 

Statutory Authority G.S. 95-25.2(16); 95-25.19; 95-245. 

.0804 NOTDJICATION AT TIME OF HDUNG 

(a) The purpose of the notice provision of G.S. 95- 
25. 13(1) is to ensure that employees know at the time of 
hiring what wages they are promised, as well as any policies 
or practices of the employer that may affect the rate or 
amount of wages. The employee shall not be subject to any 
policy or practice that decreases the employee's wages if the 
employer does not provide the employee with express notice 
orally or in writing of such policy or practice. 

(b) A dated copy of an employer's written notification of 
the promised wages bearing an employee's signature shall 
be presumptive evidence of the employer's notification to 
that employee of the information contained in the notice on 
the date stated. 

(c) If an employer fails to inform an employee at the time 
of hiring of any policy or practice regarding promised 
wages which creates additional earning prerequisites or 
which could result in a decrease in the employee's wages, 
the policy or practice shall not be effective as to that 
employee until the employee is notified of the policy or 
practice pursuant to G.S. 95-25.13(1). 

Statutory Authority G.S. 95-25.13(1); 95-25.19. 

.0805 NOTDJICATION DURING TENURE OF 
EMPLOYMENT 

(a) The purpose of G.S. 95-25.13(2) is to ensure that 
employees have ready access to a written statement of the 
employer's policies and practices regarding promised wages 
throughout their tenure with the employer so that they are 
capable of making use of the information contained therein. 



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If the employer chooses to comply with this notice require- 
ment by posting a copy of its practices and policies relating 
to the promised wages, they must be posted in such a 
manner and in such a place and during such times as to 
meet the purpose of this Section. If not so posted, the 
employer shall ensure that a written copy of such policies 
and practices is freely obtainable or easily accessible in a 
timely manner for review by the affected employees. 

(b) While not the only acceptable method for compliance, 
an employer who gives to all its employees an "employee 
handbook" or other written statement setting forth the 
policies and practices with regard to promised wages shall 
be presumed to have met the requirement of G.S. 95- 
25.13(2). 

(c) Payroll records, including check stubs, if made 
available to employees, may be used to satisfy the require- 
ment of G.S. 95-25.13(2) for wages promised in the form 
of hourly pay, salary or other form whose terms are readily 
identifiable from the payroll records. 

(d) The employer's failure to comply with the require- 
ment to have a policy or practice in writing under G.S. 95- 
25.13(2) shall not affect the employer's obligation to pay 
employees all wages promised in accordance with the 
employer's unwritten policy or practice with regard to such 
wages. 

(e) A policy or practice resulting in the loss or forfeiture 
of vacation time or pay, commissions, bonuses, or other 
forms of calculation is not subject to Paragraph (d) of this 
Rule and such policies or practices shall be unenforceable if 
they are not in writing as required under G.S. 95-25.13(2). 

Statutory Authority G.S. 95-25.13(2); 95-25.19; 95-245. 

.0806 NOTIFICATION OF CHANGES 
IN PROMISED WAGES 

(a) The purpose of G.S. 95-25.13(3) is to ensure that 
employees know of any changes La promised wages prior to 
the time of such changes, particularly changes that decrease 
their wages. The employer is required to take appropriate 
actions reasonably calculated to inform the affected employ- 
ees, in writing or through a posted notice, of such changes. 
The notice shall be such that a reasonable employee acting 
with ordinary diligence would be informed of the change in 
promised wages. 

(b) A change in an employer's policy or practice may 
occur in two ways: 

(1) in writing; or 

(2) through a succession of consistent actions taken 
by the employer which deviate from a prior 
written or unwritten policy or practice. 

(c) The determination whether the set of actions with 
regard to promised wages constitute a "change" in the 
employer's practice or policy shall be made depending on 
such factors as the number, consistency, timing and reason 
for the deviating actions. 

(d) No change in a policy and practice with regard to 
promised wages, whether in writing or not, shall be effec- 



tive until written notice is given to the employees as 
required in G.S. 95-25.13(3). except to the extent that such 
changes have the effect of increasing wages. 

Statutory Authority G.S. 95-25.13(3); 95-25.19; 95-245. 

.0807 MEANING OF "MAINTAINED IN A PLACE 
ACCESSIBLE" 

For the purposes of G.S. 95-25.13(2) and (3). the phrase 
"maintained in a place accessible" a pplies to the posting and 
to the writing. "Accessible" with respect to posting means 
"easily a pproached and viewed for reading", at a place 
designated for such purposes and regularly frequented by the 
affected employees. "Accessible" with respect to the 
writing means "easily and promptly obtained or viewed for 
reading" at a place designated for maintaining such writings. 

Statutory Authority G.S. 95-25.19; 95-245. 

.0808 METHODS OF PROVIDING EMPLOYEES 
WITH ITEMIZED STATEMENT OF 
DEDUCTIONS 

G.S. 95-25.13(4) requires the employer, in all circum- 
stances, to furnish the employee with an itemized statement 
of deductions made from that employee's wages under G.S. 
95-25.8. Generally, the employer shall provide such a 
statement in writing. However, it is also sufficient for the 
employer to furnish the employee with the itemized state- 
ment of deductions via telecommunications . for example, 
electronic mail, but only if such a transmission is capable of 
being printed out as a paper copy by the employee. 

Statutory Authority G.S. 95-25.19; 95-245. 

Notice is hereby given in accordance with G.S. 
150B-21.2 that the North Carolina Department of 
Labor intends to adopt rules pertaining to the Wage and 
Hour Act. The agency will subsequently publish in the 
Register the text of the rule(s) it proposes to adopt as a 
result of the public hearing and of any comments received on 
the subject matter. 

Statutory Authority: G.S. 95-25.1 et seq. 

Proposed Effective Date: October 1, 1995. 

A Public Hearing will be conducted at 10:00 a.m. on 
Friday June 2, 1995 at the Agriculture Building, 2 West 
Edenton Street, Room 359, Raleigh, NC. 

Reason for Proposed Action: To provide necessary rules 
for the Wage and Hour Act, particularly with regard to 
recordkeeping and youth employment issues. 

Comment Procedures: Please submit your comments to 



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Mr. Scott Templeton, APA Coordinator, N C. Department of 
Labor, 4 W. Edenton Street, Raleigh, NC 27601, FAX (919) 
715-5629; Telephone (919) 733-0368 by June 2, 1995. You 
may present written or oral comments at the hearing; 
however, time limits may be imposed by the Chair. 

Notice is hereby given in accordance with G.S. 
15 OB -2 1.2 that the North Carolina Department of 
Labor intends to adopt rules regarding the Migrant Housing 
Act of North Carolina. The agency will subsequently publish 
in the Register the text of the rule(s) it proposes to adopt as 
a result of the public hearing and of any comments received 
on the subject matter. 

Statutory Authority: G.S. 95-222 et seq. 

Proposed Effective Date: January 1, 1996. 

A Public Hearing will be conducted at 9:00 a.m. on August 
18, 1995 at the NC Department of Agriculture Building, 2 
W. Edenton Street, Room 359, Raleigh, NC 27601. 

Reason for Proposed Action: To update the administrative 
rules regarding the Migrant Housing Act. 

Comment Procedures: Please submit your comments to 
Mr. Scott Templeton, APA Coordinator, NC Department of 
Labor, 4 West Edenton Street, Raleigh, NC 27601, FAX 
(919) 715-5629; Telephone (919) 733-0368 by August 18, 
1995. You may present written or oral comments at the 
hearing; however, time limits may be imposed by the Chair. 



Labor, 4 West Edenton Street, Raleigh, NC 27601, FAX 
(919) 715-5629; Telephone (919) 733-0368 by May 18, 
1995. You may present written or oral comments at the 
hearing; however, time limits may be imposed by the Chair. 

Notice is hereby given in accordance with G.S. 
150B-21.2 that the North Carolina Department of 
Labor intends to adopt rules pertaining to the Retaliatory 
Employment Discrimination Act. The agency will subse- 
quently publish in the Register the text of the rule(s) it 
proposes to adopt as a result of the public hearing and of 
any comments received on the subject matter. 

Statutory Authority: G.S. 95-240 et seq. 

Proposed Effective Date: February 1, 1996. 

A Public Hearing will be conducted at 2:00 p.m. on 
Thursday, May 18, 1995 at the Agriculture Building, 2 West 
Edenton Street, Room 359, Raleigh, NC 2/601. 

Reason for Proposed Action: To provide rules for the 
Retaliatory Employment Discrimination Act. 

Comment Procedures: Please submit your comments to 
Mr. Scott Templeton, APA Coordinator, NC Department of 
Labor, 4 W. Edenton Street, Raleigh, NC 27601, FAX (919) 
715-5629; Telephone (919) 733-0368 by May 18, 1995. You 
may present written or oral comments at the hearing; 
however, time limits may be imposed by the Chair. 



Notice is hereby given in accordance with G.S. 
150B-21.2 that the North Carolina Department of 
Labor intends to adopt rules regarding regulation of job 
listing services. The agency will subsequently publish in the 
Register the text of the rule(s) it proposes to adopt as a 
result of the public hearing and of any comments received on 
the subject matter. 

Statutory Authority: G.S. 95-47.19 et seq. 

Proposed Effective Date: January 1, 1996. 

A Public Hearing will be conducted at 9:00 a.m. on May 
18, 1995 at the NC Department of Agriculture Building, 2 
W. Edenton Street, Room 359, Raleigh, NC 27601. 

Reason for Proposed Action: To provide administrative 
rules for the Regulation of Job Listing Services Act. 

Comment Procedures: Please submit your comments to 
Mr. Scott Templeton, APA Coordinator, NC Department of 



TITLE 15A - DEPARTMENT OF 

ENVIRONMENT, HEALTH, AND 

NATURAL RESOURCES 



Notice is hereby given in accordance with G.S. 
150B-21.2 that the EHNR - Sedimentation Control 
Commission intends to adopt rule cited as 15 A NCAC 4B 
.0028. 

Proposed Effective Date: July 1, 1995. 

A Public Hearing will be conducted at 9:00 a.m. on May 
8, 1995 at the Ground Floor Hearing Room, Archdale 
Building, 512 N. Salisbury Street, Raleigh, NC. 

Reason for Proposed Action: This new rule is needed to 
clarify the authority of the Sedimentation Control Commis- 
sion to regulate land-disturbing activities under-taken by 
railroad companies. Specifically , the Commission must 
recognize a zone of federal preemption within railroad 
rights-of-way which is established by federal law. Outside 



♦ 



149 



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10:2 



PROPOSED RULES 



this zone, the Office of the Attorney General has advised that 
the Commission does have authority to enforce the Sedimen- 
tation Pollution Control Act of 1973. 

Comment Procedures: Any person requiring information 
may contact Mr. Craig Deal, Land Quality Section, PO Box 
27687, Raleigh, NC 27611 - Telephone - (919) 733-4574. 
Written comments may be submitted to the above address no 
later than May 17, 1995. 

Fiscal Note: This Rule does not affect the expenditures or 
revenues of local government or state funds. 

CHAPTER 4 - SEDIMENTATION CONTROL 

SUBCHAPTER 4B - EROSION AND SEDIMENT 
CONTROL 



TITLE 21 - OCCUPATIONAL 
LICENSING BOARDS 

CHAPTER 1 - NORTH CAROLINA 
ACUPUNCTURE LICENSING BOARD 



Notice is hereby given in accordance with G.S. 
150B-21.2 that the North Carolina Acupuncture 
Licensing Board intends to amend rule cited as 21 NCAC 1 
.0101; adopt rules .0401 and .0402. 

Proposed Effective Date: July 1, 1995. 

A Public Hearing will be conducted at 3:00 p.m. on May 
2, 1995 at the Pack Memorial Library, 67 Haywood St. , 
Asheville, NC. 



.0028 RAILROAD COMPANIES 

(a) The Commission recognizes that under the Federal 
Railroad Safety Act of 1970 (FRSA). 45 U.S.C. 421 et 
seq.. as interpreted by federal administrative rules and court 
decisions, existing railroad roadbeds comprise a zone of 
federal preeminence within which federal law takes prece- 
dence over the Act rthe SPCA1. 

£b) While the specific definition of this zone of federal 
preeminence is a question of federal law and regulation, in 
general the zone of federal preeminence extends outward 
from the center of the railroad roadbed to and including 
drainage ditches and spoil banks on either side of the 
roadbed. 

(c) In the event of a derailment, washout, or other 
emergency condition which requires immediate action to 
protect public safety, the zone of federal preeminence 
temporarily expands, for the duration of the emergency 
condition, to encompass areas adjacent to die roadbed within 
which emergency repairs are undertaken pursuant to the 
FRSA and Federal Railroad Administration rules. 

(d) The Act and rules do not apply to activities conducted 
within the zone of federal preeminence. The Act and rules 
apply to all other activities conducted by railroad companies. 

(e) A railroad company's failure to comply with a 
requirement of the Act or rules in order to avoid creating a 
safety hazard or to avoid noncompliance with a federal 
safety requirement is not a knowing or willful violation of 
the Act or rules. 

(f) The Commission will provide advice and technical 
assistance to railroad companies in the development and 
implementation of voluntary best management practices to 
reduce environmental impacts that may otherwise result 
from activities conducted within the zone of federal preemi- 
nence. 

Statutory Authority G.S. 113A-52(6); 113A-54(b); 113A- 
54(c); U3A-54(d)(4); 113A-57(1). 



Reason for Proposed Action: 

21 NCAC 1 .0101 - This rule was adopted effective August 

1, 1994. A typographical error was made and the word 

"not " was left out. 

21 NCAC 1 .0401 & .0402 - To adopt rules to establish 

practice parameters and procedures for the practice of 

acupuncture in North Carolina. 

Comment Procedures: Any person may submit written 
comments to the Board until May 17, 1995 or speak to the 
Rule- making Coordinator at the Public Hearing on May 2, 
1995 at 3:00 p.m. at Pack Memorial Library in Asheville, 
NC. 

Fiscal Note: These Rules do not affect the expenditures or 
revenues of local government or state funds. 

SECTION .0100 - LICENSURE 

.0101 QUALIFICATIONS FOR LICENSURE 

In addition to and for the purposes of meeting the require- 
ments of G.S. 90-455 an applicant for licensure to practice 
acupuncture shall: 

(1) Submit a completed application, 

(2) Submit fees as required by Rule .0103 of this 
Section, 

(3) Submit proof of a score of not less than 70% on 
the National Commission for the Certification of 
Acupuncturists (NCCA) certifying examination or 
a score of not less than 70% from any state 
utilizing the NCCA examination, 

(4) Submit a certified copy, certified by the issuing 
institution, of a transcript including evidence of 
graduation from a three-year postgraduate acu- 
puncture college, 

(5) Submit proof of successful completion of the 
Clean Needle Technique course offered by the 
Council of Colleges of Acupuncture and Oriental 
Medicine (CCAOM), 



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150 



PROPOSED RULES 



(6) With any document that is not in English in its 
original form, submit a translation of it into 
English by someone other than the applicant. 
Each translated document shall have affixed to it 
a notarized statement of the translator certifying 
that he or she is competent in both the language of 
the original document and English and that the 
translation is a true and complete translation of the 
foreign language original. The applicant shall 
assume the cost of any document necessary for a 
complete application, 

(7) Submit all correspondence to North Carolina 
Acupuncture Licensing Board, P.O. Box 25171, 
Asheville, NC 28803. 

Statutory Authority G.S. 90-454; 90-455. 

SECTION .0400 - PRACTICE PARAMETERS 
AND PROCEDURES 

.0401 PRACTICE PARAMETERS 

The following are the practice parameters for acupunctur- 
ists in North Carolina: 

(1) A licensed acupuncturist shall practice within the 
scope of training offered by a college certified by 
the National Accreditation Commission for 
Schools and Colleges of Acupuncture and Oriental 
Medicine. 

£2} A licensed acupuncturist must practice within the 
confines of his training. Parameters for diagnosis 
and treatment of patients include. Five Elements. 
Eight Principles, Yin Yang Theory, Channel 
Theory. Organ Theory. Six Stage and 4 Aspects 
of Disease Progressions. 

Statutory Authority G. S. 90-454. 

.0402 ACUPUNCTURE PROCEDURES 

The following procedures shall be followed within the 
practice of acupuncture: 
(1) Practice Setting: 
(a) Treatments shall be given in surroundings that 

provide privacy and confidentiality. 
£b) Every acupuncture office shall be maintained in 
a clean and sanitary condition at all times, and 
shall have a readily accessible bathroom facility. 
(c) OSHA Standards for Blood Borne Pathogens 
shall be met. 
New Patient Intake: 



01 

£al 



Ibj 



Prior to treatment, a written or oral medical 
history shall be obtained from the patient. Oral 
statements shall be reflected in the practitioner's 
notes. Information shall include current and past 
medical illnesses, treatments, hospitalizations, 
current medications and allergies to medications. 
A social history shall include use of tobacco, 
alcohol, caffeine and recreational drugs. 
The names of current health practitioners shall 






121 

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be listed. 

The current complaints shall be outlined along 
with remedies and treatments tried and in prog- 
ress. 

The possibility of pregnancy or the presence of 
biomedical devices, such as artificial joints or 
cardiac pacemaker shall be ascertained. 

Fees. Information concerning fees shall be made 

available prior to treatment. 

Guarantees. No guarantee or implied guarantee 

about the success of treatment shall be given. 

Reasonable indication of the length of treatment 

and usual outcome shall be given. 

Diagnosis: 
Diagnosis shall be made utilizing methods 
connected with the traditions represented in 
Chinese medicine as listed in Rule .0104 of this 
Chapter. Examples of diagnostic measures 
include the Eight Principles. Five Elements. 



Pulse diagnosis, and Tongue diagnosis. 
The diagnostic procedures shall be recorded at 
each visit- 
Treatment. The specifies of the treatment shall be 
recorded at each visit- 
Medical Records. Dated notes of each patient 
visit and communication shall be kept. These 
records may only be made available to other 
parties with the patients's written authorization. 
Failure to Progress: 
If a patient fails to respond to treatments as 
expected, discussion about other forms of treat- 
ment or referral to another health care profes- 
sional shall be made. 

In the case of persistent, unexplained pain, or 
the unexplained worsening of any condition in 
the face of ongoing treatment, referral or consul- 
tation shall be made. In choosing a referral 
source, priority shall be given to previously seen 
practitioners if possible- 
Requests by the patient for information about 
other forms of treatment or referral shall always 
be honored. 



Statutory Authority G. S. 90-454. 

CHAPTER 32 - BOARD OF MEDICAL 
EXAMINERS 



Notice is hereby given in accordance with G.S. 
150B-21.2 that the Board of Medical Examiners of the 
State of North Carolina intends to amend rules cited as 21 
NCAC 32H .0102, .0201, .0601 - .0602, .0801, .1001; 321 
.0003 - .0004 and adopt 32H .0203, .0408, and .0506. 



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PROPOSED RULES 



Proposed Effective Date: 21 NCAC 32H .0102, .0201, 
.0203, .0408, .0506, .0602, .0801, .1001 -July 1, 1996. 
21 NCAC 32H . 0601; 321 . 0003 - . 0004 - July 1 , 1995. (4) 

A Public Hearing will be conducted at 1:00 p.m. on May 
3, 1995 at the North Carolina Division of Facility Services, 
701 Barbour Drive, Room 201, Raleigh, NC 27603. 

Reason for Proposed Action: 

21 NCAC32H .0102, .0201, .0203, .0408, .0506, .0602, (5) 

.0801, .1001 - To establish rules for a new class of ALS 

Professionals who will work as dispatchers. 

21 NCAC 32H .0601 - To deliniate grounds for disciplinary 

actions against ALS Professionals. 

21 NCAC 321 .0003 - .0004 - To extend the approval period 

for use of Epinephrine for adverse reaction to bee stings 

from 1 year to 4 years. (6) 

Comment Procedures: Persons interested may present 
written or oral statements relevant to the proposed actions 
at a hearing to be held as indicated above. Written state- 
ments not presented at the hearing should be directed to: 
Administrative Procedures, NC Board of Medical Examiners, 
PO Box 20007, Raleigh, NC 27619, no later than May 17, (7) 

1995. 

Fiscal Note: These Rules do not affect the expenditures or 
revenues of local government or state funds. 

SUBCHAPTER 32H - EMERGENCY MEDICAL 
SERVICES ADVANCED LIFE SUPPORT 

SECTION .0100 - GENERAL INFORMATION 

.0102 DEFINITIONS 

The following definitions apply in this Subchapter: 

(1) "Audit and review panel" means a committee 
composed of representatives of the medical, 
nursing, administrative and prehospital care 
service elements of an advanced life support 
(ALS) program that has the responsibility for the 
on-going monitoring and evaluation of the pro- 
gram. The chairman of the panel shall be a 
physician and a majority of the voting members (10) 
shall be physicians. 

(2) "Emergency medical technician-advanced interme- 
diate (EMT-AI)" means a person specially edu- 
cated in a program approved by the Office of 
Emergency Medical Services who has been certi- 
fied or recertified by the Board of Medical Exam- 
iners as qualified to render the services enumer- 
ated in Rule .0406 of this Subchapter. 

(3) "Emergency medical technician-defibrillation 
(EMT-D)" means a person specially educated in a (11) 
program approved by the Office of Emergency 
Medical Services who has been certified or recer- 
tified by the Board of Medical Examiners as 



(8) 
(9) 



qualified to render the services enumerated in Rule 
.0407 of this Subchapter. 

"Emergency medical technician-intermediate 
(EMT-I)" means a person specially educated in a 
program approved by the Office of Emergency 
Medical Services who has been certified or recer- 
tified by the Board of Medical Examiners as 
qualified to render the services enumerated in Rule 
.0403 of this Subchapter. 

"Emergency medical technician-paramedic (EMT- 
P)" means a person specially educated in a pro- 
gram approved by the Office of Emergency 
Medical Services who has been certified or recer- 
tified by the Board of Medical Examiners as 
qualified to render the services enumerated in Rule 
.0402 of this Subchapter. 

"Advanced Life Support Professional (ALS Pro- 
fessional)" means a certified emergency medical 
dispatcher, emergency medical technician-defibril- 
lation, emergency medical technician-intermediate, 
emergency medical technician-advanced intermedi- 
ate, or emergency medical technician-paramedic 
whether working on a paid or volunteer basis. 
"Medical control" means the management and 
accountability for the medical care aspects of an 
ALS program. It entails physician direction and 
oversight of the initial education and continuing 
education of the ALS professionals; development 
and monitoring of both operational and treatment 
protocols; evaluation of the medical care rendered 
by ALS personnel; participation in system evalua- 
tion; and directing, by radio or telephone, the 
medical care rendered by the ALS professionals. 
"Medical director" means the physician responsi- 
ble for the medical aspects of the management of 
an ALS program. 

"Mobile intensive care nurse (MICN)" means a 
registered nurse who has been approved or 
reapproved by the Board of Medical Examiners to 
issue instructions to ALS professionals in accor- 
dance with protocols approved by the sponsor 
hospital and under the direction of the medical 
director. 

"Advanced life support program (ALS program)" 
means a program of prehospital emergency medi- 
cal care whereby definitive medical care is deliv- 
ered to a victim of sudden injury or illness by 
appropriately educated and certified ALS profes- 
sionals operating under the direction of a sponsor 
hospital. All ALS programs shall conform to the 
criteria established in the rules contained in this 
Subchapter and must be approved by the Office of 
Emergency Medical Services. 
"Mobile intensive care unit" means any emergency 
vehicle staffed by ALS professionals and equipped 
in accordance with standards established by the 
North Carolina Medical Care Commission as 



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152 



PROPOSED RULES 



found in 10 NCAC 3M .0202, .0203, .0204, 
.0205, and .0207 to provide remote intensive care 
to sick and injured persons at the scene of a 
medical emergency and during transport to a 
health care facility. 

(12) "Oral interview panel" means a committee com- 
posed of physicians, ALS professionals certified at 
or above the level of application and may include 
other medical personnel such as registered nurses 
and mobile intensive care nurses involved in the 
ALS program. The responsibility of the oral 
interview panel is to interview each applicant for 
certification, either collectively or individually, 
and evaluate his suitability to perform successfully 
at the certification level sought. The panel must 
be approved by the medical director and consist of 
a minimum of three members including one 
physician and one ALS professional. 

(13) "Office of Emergency Medical Services" means an 
official agency of the State of North Carolina, 
Department of Human Resources, that serves in 
an administrative capacity to the Board of Medical 
Examiners. 

(14) "Physician" means an individual licensed by the 
Board of Medical Examiners to practice medicine 
in the State of North Carolina. 

(15) "Sponsor hospital" means a hospital and its medi- 
cal staff which participates in an ALS program 
and has responsibility for providing or ensuring 
the provision of initial education, continuing 
education, education and medical control to the 
ALS professionals. The sponsor hospital shall 
meet criteria adopted by the Board of Medical 
Examiners and be approved by the Office of 
Emergency Medical Services. 

(16) "Study project" means a proposal involving excep- 
tions to the provisions of this Subchapter for the 
purpose of evaluating the efficiency and effective- 
ness of alternate means of providing ALS services 
to the citizens of North Carolina. 

(17) "Blind insertion airway device" means an airway 
adjunct designed to be used as a pharyngeal or 
esophageal device which is inserted without the 
use of direct visualization. For the purposes of 
these Rules, this definition does not include 
esophageal obturator airways, esophageal gastric 
tube airways, or endotracheal tubes. 

(18) "Coding" means the selection and assignment of 
an alphanumeric classification to a call for medical 
assistance by an EMD. 

(19) "Emergency Medical Dispatcher (EMD)" means 
a trained public safety telecommunicator with 
additional training and specific emergency medical 
knowledge essential for the efficient management 
of emergency medical service communications 
who has successfully completed an education and 
training program meeting the criteria established 
by the Office of Emergency Medical Services and 



who functions as an a gent or constituent of an 
Emergency Medical Dispatch Program approved 
by the Office of Emergency Medical Services. 

(20) "Emergency Medical Dispatching " means the 
reception and management of requests for emer- 
gency medical assistance. 

(21) "Emergency Medical Dispatch Program" means 
the a pproved program with procedures established 
for the management and delivery of emergency 
medical assistance by a public or private agency 
that sends emergency medical assistance to re- 
questing persons and provides pre-arrival instruc- 
tions for a victim of sudden injury or illness. 

(22) "Emergency Medical Dispatch Priority Reference 
System (EMDPRS)" means a medically approved 
written or computer generated reference system 
used by an emergency medical dispatching agency 
to provide medical direction, and to dispatch aid 
to medical emergencies. 

(23) "EMD selection" means the process which estab- 
lishes criteria to identify a candidate for education 
and training as an Emergency Metiical Dispatcher 
(EMD). 

(24) "Pre-arrival instructions" means telephone ren- 
dered, medically approved written instructions 
read by emergency medical dispatchers to callers, 
which help provide aid to the victim and control 
the situation prior to patient access by pre-hospital 
care providers. 

(25) "Public Safety Telecommunicator* means an 
individual trained to communicate by electronic 
means with persons seeking emergency assistance 
and with public or private agencies and individuals 
providing such assistance. 

(26) "A pproved Teaching Institution" means an agency 
with a current contract with the Office of Emer- 
gency Medical Services to provide emergency 
medical services training programs. 

Statutory Authority G.S. 143-514. 

SECTION .0200 - PROGRAM STANDARDS 
AND APPROVAL 

.0201 ADVANCED LIFE SUPPORT PROGRAM 
CRTTERIA 

ALS programs shall cover a defined service area of 
generally not less than one county and must have the 
following: 

(1) a plan, as specified in Rule .0302 of this Subchap- 
ter, for the coordination of the sponsor hospitals 
participating in the program; 

(2) a designated medical director who shall be respon- 
sible either directly or by clearly established 
delegation to the other licensed physicians at the 
sponsor hospital(s) for the following: 

(a) the initial establishment,, a pproval and periodic 
updating of treatment protocols or EMDPRS for 



♦ 



153 



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April 17, 1995 



10:2 



PROPOSED RULES 



I 



% 



emergency medical dispatch pro grams ; 

(b) medical supervision of the selection, initial 
education, continuing education and performance 
of the ALS professionals and MICN personnel; 

(c) the medical review of the care provided to 
patients; 

(d) keeping the care provided current with advanced 
biomedical science and technology; and 

(e) participation in the overall management of the 
ALS program in liaison with nursing, technical, 
and administrative staff of the program. The 
medical director has the authority to suspend 
temporarily, pending due process review, an 
ALS professional or MICN from further partici- 
pation in the ALS program when it is deter- 
mined the activities or medical care rendered by 
such personnel may be detrimental to the care of 
the patient; 

an organized and defined system of communica- 
tions that provides for: 
public access through a central emergency 
communications center; 

dispatch and coordination of all resources (man- 
power, vehicles and equipment) essential to the 
effective and efficient management of requests 
for emergency medical assistance; 
communications linkages for interacting with 
other public safety agencies to obtain additional 
resources required to support emergency medical 
services activities; and 

two-way voice communications as specified in 
Rule .0303(a)(2)(H) of this Subchapter between 
the ALS professionals and the personnel at the 
sponsor hospital responsible for directing the 
medical treatment rendered by the ALS profes- 
sionals; 

(4) adequate certified manpower to ensure that the 
program will be continuously available on a 24 
hour-a-day basis; and 

(5) an audit and review panel that meets at a mini- 
mum on a quarterly basis and whose responsibili- 
ties include at least the following: 

(a) reviewing ALS cases to determine the appropri- 
ateness of the medical care rendered by all 
personnel involved in the cases; 

(b) making recommendations to the medical director 
for the continuing education program for ALS 
personnel; and 

(c) reviewing the policies, procedures and protocols 
of the ALS program and making recommenda- 
tions for improvement. 

Statutory Authority G.S. 143-514. 

.0203 APPROVAL REQUIREMENTS: EMERGENCY 
MEDICAL DISPATCHER PROGRAM 

(a) All emergency medical dispatching agencies applying 



(3) 
(a) 
(b) 

(c) 

(d) 



the principles of EMD or offering EMD services, proce- 
dures, or programs to the public shall conform to the 
criteria established in the rules contained in this Subchapter 
and shall submit a proposal for program a pproval to the 
Office of Emergency Medical Services at least 60 days prior 
to program implementation. The proposal must document 
that the EMD program has: 



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a defined service area: 

a designated medical director responsible for 
medical supervision of the program in accor- 
dance with Rule .020U2)(a.)-(e) of this Section: 
adopted, maintains, and updates on a regular 
basis, a written or computer-based emergency 
medical dispatch priority reference system 
(EMDPRS) a pproved by the EMD program 
medical director including at least the minimum 
incident protocols set forth in the "Guidelines 
for the Development and Operation of Emer- 
gency Medical Dis patch Programs" dated March 
1995. incorporated herein by reference: 
adequate personnel certified in accordance with 
the requirements of this Subchapter to ensure 
that the program will be continuously available 
on a 24 hour-a-day basis; 
an organized and defined system of communica- 
tions that provides for public access through a 
central emergency communications center using 
a single seven digit telephone number for the 
service area or an emergency 9-1-1 telephone 
system; 

the ability to dispatch and coordinate all re- 
sources, such as manpower, vehicles and equip- 
ment that are essential to the effective and 
efficient management of requests for emergency 
medical assistance: 

an audit and review panel which meets at a 
minimum on a quarterly basis; 
a formal written policy delineating the proce- 
dures for individuals to be trained and/or em- 
ployed as emergency medical dispatchers. The 
policy shall address: 
Provision for EMD selection in a manner that 
ensures ability to function in the program; 
Provision for initial EMD training and EMD 
certification; 

Probationary on the job EMD experience: 
Provision of continuing professional EMD 
education; 

Recertification of EMDs functioning in the 
program; 

Requisite basic medical familiarization includ- 
ing CPR and Heimlich maneuver training; 
Exposure to EMS field operations and EMS 
system familiarization; 
a formal risk management program including 
written procedures that provide: 
(A) The chain of command for establishment of 



(A) 

£S1 



(G) 



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154 



PROPOSED RULES 



policies, procedures, and resolution of con- 
flicts relating to the EMD Program; 

(B) Administrative procedures and written proto- 
cols for resource allocation and alternative 
response assignments of emergency response 
units; 

(C) EMD responsibilities in special situations, such 
as disasters, multi-causality incidents, or 
situations requiring referral to specialty hot- 
lines; 

(D) Complete written and recorded documentation 
of EMD operations that permit timely medical 
audit and review; 

(E) Procedures for selection and processing of 
cases for EMD audit and review; 

(10) adopted and maintains a dispatch coding system 
consistent with the incident protocol types in the 
EMDPRS which categorizes the problem deter- 
mination through the EMDs evaluation of the 
problem or situation; 
(111 provides, maintains, and upgrades on a regular 
basis, all necessary protocols, training equip- 
ment, and quality assurance/case review equip- 
ment and su pplies required for operation of the 
EMD program, 
(b) Make application to the Office of Emergency Medical 
Services and te re-approved every four years following 
initial EMD program approval. 

Statutory Authority G.S. 143-514. 

SECTION .0400 - EDUCATION AND 

PERFORMANCE OF ADVANCED LD7E 

SUPPORT 

.0408 EMERGENCY MEDICAL DISPATCHER 
PERFORMANCE 

EMDs educated in approved training programs, when 

certified by the Board of Medical Examiners, and while 

functioning in an approved Emergency Medical Dispatch 

program, may do the following in compliance with the 

protocols established in the emergency medical dispatch 

priority reference protocol system approved by the program 

medical director: 

(1") Receive and process calls for medical assistance in 

a standardized manner, using the a pproved 

EMDPRS protocol to elicit required information 

for evaluating, advising, and treating sick or 

injured individuals, and dispatching an appropriate 

EMS response. 

(2) Provide pre-arrival instructions to the patient 

through the caller when possible and appropriate 

to do so while functioning in compliance with the 

EMDPRS. 

Statutory Authority G.S. 143-514. 

SECTION .0500 - CERTIFICATION AND 



APPROVAL REQUIREMENTS FOR ADVANCED 
LD7E SUPPORT PERSONNEL 

.0506 CERTDJICATION REQUIREMENT: 

EMERGENCY MEDICAL DISPATCHER 

(a) To become certified as an EMD. a person must meet 
the following criteria: 

(1) be at least 18 years of age; 

(2) be affiliated on a continuous basis with an 
emergency medical dispatch program approved 
by the Office of Emergency Medical Services; 

(3) successfully complete, within one year prior to 
application, an American Heart Association 
(AHA) Level U C cardiopulmonary resuscitation 
(CPR) course or equivalent; 

(4) successfully complete, within one year prior to 
application, an approved EMD educational 
program meeting the requirements of the 
"Guidelines for Development and Operation of 
Emergency Medical Dispatch Programs" dated 
March 1995 incorporated herein by reference. 
If the educational program was completed over 
one year prior to application, a person must 
submit evidence of completion of pertinent 
continuing education in emergency medical 
dispatch taken in the past year and have the 
continuing education a pproved by the Office of 
Emergency Medical Services; 

(5) successfully complete an evaluation conducted 
under the direction of the medical director of the 
EMD program assessing the ability to perform 
the skills and procedures specified in Rule .0408 
of this Subchapter; and be recommended for 
certification examination: 

(6) pass the EMD written examination administered 
by the Office of Emergency Medical Services. 

(b) Persons holding current certification equivalent to 
EMD with an approved emergency medical dispatch 
certification agency or in another state where the educational 
and certification requirements have been a pproved for legal 
recognition by the Office of Emergency Medical Services 
may become certified by: 

(1) presenting evidence of such certification for 
verification by the Office of Emergency Medical 
Services; and 

(2) meeting the criteria specified in Subparagraphs 
(a)(1). (a)(2). (a)(3). and (a)(5) of this Rule. 

(c) Certification obtained through legal recognition shall be 
valid for four years or the unexpired term of the certifica- 
tion that was used to obtain a certification in this state, 
whichever is shorter. All certifications shall be valid for the 
period stated on the certificate issued to the applicant by the 
Office of Emergency Medical Services. This period shall 
not exceed four years. Persons must be recertified by 
presenting documentation to the Office of Emergency 
Medical Services that they have successfully completed 
either of the following options: 

OPTION I: 



♦ 



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PROPOSED RULES 



(1) an ongoing continuing education program under 
the direction of the medical director, meeting the 
requirements of "Guidelines for Development 
and Operation of Emergency Medical Dispatch 
Programs" dated March 1995 incorporated 
herein by reference. 

(2) an EMD performance evaluation conducted 
under the direction of the medical director 
meeting the requirements of "Guidelines for 
Development and Operation of Emergency 
Medical Dispatch Programs" dated March 1995 
incorporated herein by reference assessing the 
ability to perform the skills specified in Rule 
.0408 of this Subchapter; and 

(3) an EMD written examination administered by 
the Office of Emergency Medical Services; or 

OPTION n: 

£1} the criteria specified in (1) and (2) of OPTION 

I of this Rule: and 
(2) a written examination following guidelines 
established by the Office of Emergency Medical 
Services and administered under the direction of 
the medical director in compliance with the test 
specifications of the state EMD written examina- 
tion. 

Statutory Authority G.S. 143-514. 

SECTION .0600 - ENFORCEMENT 

.0601 GROUNDS FOR DENIAL, SUSPENSION, 
OR REVOCATION 

(a) The Board of Medical Examiners may deny, suspend 
or revoke the approval of an ALS program^ EMD program 
or sponsor hospital for any of the following reasons: 

(1) failure to comply with the requirements as found 
in Sections .0200 and .0300 of this Subchapter; 
or 

(2) obtaining approval through fraud or misrepresen- 
tation. 

(b) The Board of Medical Examiners may deny, suspend 
or revoke the certification of an ALS professional or the 
approval of a MICN for any of the following reasons: 

(1) failure to comply with the applicable perfor- 
mance and certification and approval require- 
ments as found in these Rules .0102, .0403, 
.0404, .0406, .0407, .0501, .0502, .0503, 
.050 4 , and .0505 of this Subchapter ; 

(2) obtaining or attempting to obtain certification, 

r e o e rtifioation, approval or r e approval through 
fraud or misr e pr e s e ntation; 

(3) aiding a person in obtaining or attempting to 

obtain certification, rocortification, approval or 
r e approval through fraud or misr e pr e s e ntation; 

f4) failur e — to — perform a pr e oorib e d — procedur e , 

failure to perform a proscribed procedure com 
potently or performance of a procedure which is 



not within the scope and responsibility of the 
oertif i oat e hold e r; 

(S) performanc e of a proc e dur e whioh is d e trim e ntal 

to the health and safety of a patient; 
any felony conviction. 



121 



£41 



(5) 



immoral or dishonorable conduct: 
making false statements or representations to the 
Board of Medical Examiners or the Office of 
Emergency Medical Services or willfully con- 
cealing of material information in connection 
with an a pplication for certification or a pproval; 
being unable to perform as an ALS Professional 
or MICN with reasonable skill and safety to 
patients and the public by reason of illness, 
drunkenness, excessive use of alcohol, drugs, 
chemicals, or any other type of material or by 
reason of any physical or mental abnormality; 
unprofessional conduct, including but not limited 
to a failure to comply with the rules relating to 
the proper function of an ALS Professional or 
MICN contained in this Subchapter or the per- 
formance of or attempt to perform a procedure 
which is detrimental to the health and safety of 
a patient or which is beyond the scope and 
responsibility of the ALS Professional or MICN; 
conviction in any court of a crime involving 
moral turpitude, a conviction of a felony, or 
conviction of a crime involving the function of 
an ALS Professional or MICN; 
by false representations obtaining or attempting 
to obtain money or anything of value from a 
patient; 

adjudication of mental incompetency; 
lack of professional competence to practice with 
a reasonable degree of skill and safety for 
patients including but not limited to a failure to 
perform a prescribed procedure, failure to 
perform a prescribed procedure competently or 
performance of a procedure which is not within 
the scope of official duties of the ALS Profes- 
sional or MICN; 

failure to respond within a reasonable period of 
time and in a reasonable manner to inquiries 
from the Board of Medical Examiners of the 
Office of Emergency Medical Services concern- 
ing any matter relating to the practice of an ALS 
Professional or an MICN; 
testing positive for substance abuse by blood, 
urine or breath testing while on duty as an ALS 
Professional or MICN; or 
representing or allowing others to represent that 
the ALS Professional or MICN is a physician or 
otherwise has a certification or a pproval that the 
ALS Professional or MICN does not in fact 
have. 



Statutory Authority G.S. 143-514. 



£6) 



(D 



m 

£21 



(10) 



an 

02) 



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156 



PROPOSED RULES 



.0602 PROCEDURES FOR DENIAL: SUSPENSION 
OR REVOCATION 

(a) The Board of Medical Examiners may deny, suspend 
or revoke the certification of an ALS professional or the 
approval of a MICN, sponsor hospital, EMD program or 
ALS program in accordance with Article 3A of Chapter 
150B. 

(b) Notwithstanding Paragraph (a) of this Rule, the Board 
of Medical Examiners may summarily suspend the certifica- 
tion of an ALS professional, the approval of a MICN, 
sponsor hospital, EMD program or ALS program as 
specified in G. S. 150B-3(c). 

Statutory Authority G.S. 143-514. 

SECTION .0800 - FORMS 

.0801 REQUIRED FORMS AND DOCUMENTS 

(a) The following forms are required for certification or 
approval: 

(1) Certification Application Form; 

(2) ALS Personnel Verification Form. 

(b) The following documents are required for educational 
and evaluation programs and referenced in the Rules: 



(1) 
(2) 
(3) 
(4) 
(5) 
(6) 



(7) 
(8) 



m 



"North Carolina EMT-P Curriculum Outline"; 
"North Carolina EMT-AI Curriculum Outline"; 
"North Carolina EMT-I Curriculum Outline"; 
"North Carolina EMT-D Curriculum Outline"; 
"North Carolina MICN Curriculum Outline"; 
"Guidelines for Continuing Education and Per- 
formance Evaluation of Emergency Medical 
Services Advanced Life Support Personnel"; 
"Guidelines for Reapproval of Mobile Intensive 
Care Nurses"; and 

"Guidelines for the Selection and Performance 
of the Emergency Medical Services Nurse 
Liaioon". Liaison"; 

"Guidelines for Development and Operation of 
Emergency Medical Dispatch Programs". 



Statutory Authority G.S. 143-514. 

SECTION .1000 - MEDICAL CONTROL 

.1001 MEDICAL CONTROL PROCEDURES 

Each ALS program must have procedures established to 
ensure medical control over the medical care rendered in the 
ALS program. This shall include, at a minimum: 

(1) a designated medical director to carry out the tasks 
as specified in Rule .0201(2)(a)-(e) of this Sub- 
chapter; 

(2) treatment protocols or a pproved emergency medi- 
cal dispatch priority reference system (EMDPRS) ; 

(3) operational protocols for obtaining medical direc- 
tion from the sponsor hospital(s); and 

(4) audit and review of the medical care rendered in 
the program. 



Statutory Authority G.S. 143-514. 

SUBCHAPTER 321 - EPINEPHRINE FOR 
ADVERSE REACTIONS TO INSECT STINGS 

.0003 APPROVAL 

A certification by the physician from whom the individual 
has received instruction as required in Rule .0002 of this 
Subchapter, certifying that such individual has satisfactorily 
completed such training program shall be filed with the 
N.C. Office of Emergency Medical Services. Upon 
recommendation of the Office of Emergency Medical 
Services, the Board will approve applicants to administer 
epinephrine for the treatment of adverse reactions to insect 
stings. This approval will be effective for on e y e ar four 
years . 

Statutory Authority G.S. 143-509(9). 

.0004 FORMS 

Forms may be obtained from the Office of Emergency 
Medical Services, Division of Facility Services, Department 
of Human Resources, 701 Barbour Drive P.O. Box 29530 . 
Raleigh, N.C. 33603 27626-0530 . 

Statutory Authority G.S. 143-509(9). 

CHAPTER 58 - REAL ESTATE COMMISSION 

Notice is hereby given in accordance with G.S. 
150B-21.2 that the North Carolina Real Estate Com- 
mission intends to amend rules cited as 21 NCAC 58A 
.0110, .0504 - .0506, .1703, .1707 - .1708, .1710 - .1711; 
58E .0103, .0203 - .0204, .0303 - .0305, .0406 - .0407, 
.0506; and adopt 58E .0515. 

Proposed Effective Date: July 1, 1995. 

A Public Hearing will be conducted at 9:00 a. m. on May 
3, 1995 at the North Carolina Real Estate Commission, 
1313 Navaho Drive, Raleigh, NC. 

Reason for Proposed Action: 

21 NCAC 58A .0110, .0504 - .0506 - to codify changes in 

requirements and procedures concerning broker-in-charge , 

license status, license reinstatement and supervision of 

salesman by broker in light of the real estate continuing 

education requirement. 

21 NCAC 58A .1703, .1707 - .1708, .1710 - .1711 - to 

refine and clarify requirements and procedures concerning 

continuing education for real estate licensees. 

21 NCAC 58E .0103, .0203 - .0204, .0303 - .0305, .0406 - 

.0407, and .0506 - to refine and clarify procedures and 

standards for the real estate continuing education program. 



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PROPOSED RULES 



21 NCAC 58E .0515 - to codify allowable deviations from 
Commission rules regarding conduct of continuing education 
courses when the rules conflict with a course sponsor's 
obligation to comply with the Americans With Disabilities 
Act. 

Comment Procedures: Comments regarding the rules may 
be made orally or submitted in writing at the public hearing. 
Written comments not submitted at the hearing may be sent 
to or delivered to Mr. Stephen L. Fussell c/o North Carolina 
Real Estate Commission, PO Box 17100, Raleigh, NC 
27619-7100, through May 17, 1995. 

Fiscal Note: These Rules do not affect the expenditures or 
revenues of local government or state funds. 

SUBCHAPTER 58A - REAL ESTATE BROKERS 
AND SALESMEN 

SECTION .0100 - GENERAL BROKERAGE 

.0110 BROKER-IN-CHARGE 

(a) There shall be designated for each firm and branch 
office thereof one broker who shall assume responsibility at 
such office for: 

(1) the proper display of license certificates of the 
brokers and salesmen associated with or engaged 
on behalf of the firm at such office, auoertn i ning 
whether and assuring that each licensee em- 
ployed at the office has complied with Rules 
.OSC^ .0504 and .0506 of this Subchapter; 

(2) the proper notification to the Commission of any 
change of business address or trade name of the 
firm and the registration of any assumed busi- 
ness name adopted by the firm for its use; 

(3) the proper conduct of advertising by or in the 
name of the firm at such office; 

(4) the proper maintenance at such office of the trust 
or escrow account of the firm and the records 
pertaining thereto; 

(5) the proper retention and maintenance of records 
relating to transactions conducted by or on 
behalf of the firm at such office; 

(6) the proper supervision of salesmen associated 
with or engaged on behalf of the firm at such 
office in accordance with the requirements of 
Rule .0506 of this Subchapter; and 

(7) the verification to the Commission of the experi- 
ence of any salesman at such office who may be 
applying for licensure as a broker. 

No broker shall be broker-in-charge of more than one 
office or branch office. 

(b) When used in this Rule, the term: 

(1) "Branch Office" means any office in addition to 
the principal office of a broker which is operated 
in connection with the broker's real estate 
business; and 



(2) "Office" means any place of business where acts 
are performed for which a real estate license is 
required. 

(c) A broker-in-charge must continually maintain his 
license on active status. 

(d) Each broker-in-charge shall notify the Commission in 
writing of any change in his status as broker-in-charge 
within 10 days following the change. Within 10 days 
following termination of his supervisory responsibilities over 
any salesman, the broker-in-charge shall provide the 
salesman, in a form prescribed by the Commission, an 
accurate written statement regarding the number and type of 
properties listed, sold, bought, leased or rented for others 
by the salesman while under the supervision of the broker- 
in-charge. 

Statutory Authority G.S. 93A-3(c). 

SECTION .0500 - LICENSING 

.0504 ACTIVE AND INACTIVE LICENSE STATUS 

(a) Except for licenses that have expired or that have been 
revoked, suspended or surrendered, all licenses issued by 
the Commission shall be designated as being either on active 
status or inactive status. The holder of a license on active 
status may engage in any activity requiring a real estate 
license and may be compensated for the provision of any 
lawful real estate brokerage service. The holder of a license 
on inactive status may not engage in any activity requiring 
a real estate license, including the referral for compensation 
of a prospective seller, buyer, landlord or tenant to another 
real estate licensee or any other party. A licensee holding 
a license on inactive status must renew such license and pay 
the prescribed license renewal fee in order to continue to 
hold such license. The Commission may take disciplinary 
action against a licensee holding a license on inactive status 
for any violation of Chapter 93A of the General Statutes of 
North Carolina or any rule promulgated by the Commission, 
including the offense of engaging in an activity for which a 
license is required while a license is on inactive status. 

(b) Upon initial licensure, a salesman's license shall be 
assigned by the Commission to inactive status and the 
license of a broker or corporate broker shall be assigned to 
active status. The license of a broker, salesman or corpo- 
rate broker shall be assigned by the Commission to inactive 
status upon the written request of the licensee. A sales- 
man's license shall be assigned by the Commission to 
inactive status by the Commission when the salesman is not 
under the active, personal supervision of a broker-in-charge. 
A corporate broker's license shall be assigned by the 
Commission to inactive status when the corporation does not 
have a principal broker. A broker or salesman shall also be 
assigned to inactive status if, upon the second renewal of his 
license following initial licensure, or upon any subsequent 
renewal, he has not satisfied the continuing education 
requirement described in Rule .1702 of this Subchapter. 

fe) — A salesman's inactive licen s e s hall bo assigned to 



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158 



PROPOSED RULES 



active status upon receipt by tho Commission of tho properly 
completed form prooorib e d in Rul e .0506(b) of thi s S e otion, 
upon pr e o e ntation of e vidonoo that h e has obtained any 
continuing education that may bo required by Rule . 1703 of 
this Subchapter, and upon submission of an affidavit, on a 
form prooorib e d by th e Commiooion, dosoribing any involv e 
mont in roal estate brok e rag e th e oal e oman may hav e had 
while his license was inactive. — A broker's inactive lioonso 
shall bo assigned to active status upon tho written request of 
the broker on a form proooribed by th e Commiooion, upon 
presentation of e vid e nc e that ho has obtain e d any continuing 
education that may bo required by Rulo .1703 of this 
Subchapter, and upon submission of an affidavit, on a form 
preooribod by th e Commission, d e ooribing any involv e m e nt 
in real e state brok e rag e the broker may havo had while his 
license was inactive. — A corporate broker's inactive lioonso 
shall bo assigned to active status upon designation in writing 
of a principal broker or upon r e instat e m e nt of tho e xpir e d 
l i c e ns e of th e loot designated prinoipal brok e r and upon 
submission by tho principal broker of an affidavit, on a 
form proscribed by tho Commission, de s cribing any involve 
mont in real e state brokerag e the corporation ma)' have had 
while ito lioonso was inactiv a - 
te) A salesman with an inactive license who desires to 
have such license placed on active status must comply with 
the procedures prescribed in Rule .0506 (b) of this Section. 
£d) A broker with an inactive license who desires to have 
such license placed on active status shall file with the 
Commission a request for license activation on a form 
prescribed by the Commission containing identify inn 
information about the broker, a list of Commission-approved 
continuing education courses completed by. the broker within 
the previous 30 days, a statement that the broker has 
satisfied the continuing education requirements prescribed by 
Rule .1703 of this Subchapter, the date of the request, and 
the signature of the broker. Upon the mailing or delivery 
of this form, the broker may engage in real estate brokerage 
activities requiring a license; however, if the broker does 
not receive from the Commission a written acknowledge- 
ment of the license activation within 30 days of the date 
shown on the form, the broker shall immediately terminate 
his real estate brokerage activities pending receipt of the 
written acknowledgement from the Commission. If the 
broker is notified that he is not eligible for license activation 
due to a continuing education deficiency, the broker must 
terminate all real estate brokerage activities until such time 
as the continuing education deficiency is satisfied and a new 
request for license activation is submitted to the Commis- 
sion. 

Statutory Authority G.S. 93A-3(c); 93A-4(d); 93A-4A; 93A-6. 

.0505 REINSTATEMENT OF EXPIRED LICENSE 

(a) Licenses expired for not more than 12 months may be 
reinstated upon proper application and payment of the 
twenty-five dollar ($25.00) renewal fee plus five dollar 
($5.00) late filing fee. In order to reinstate such license on 
active status for a license period beginning on or after July 



1, 1995, the applicant shall also present evidence satisfac- 
tory to the Commission of having obtained such continuing 
education as is required by Rule . 1703 of this Subchapter to 
change an inactive license to active status , except that tho 
time during which tho lioonso was oxp i rod shall also count 
ao inactiv e tim e for th e purpos e of determining th e amoun t 
of continuing e duoation e l e ctiv e credit hours required . A 
person reinstating such a license on inactive status shall not 
be required to have obtained any continuing education in 
order to reinstate such license; however, in order to subse- 
quently change his reinstated license from inactive status to 
active status, the licensee must satisfy the continuing 
education requirement prescribed in Rule .1703 of this 
Subchapter and th e tim e during which the lioono e was 
expired shall also count ao inactive time for tho purpooo of 
determining tho amount of continuing education elective 
credit hours required . 

(b) Reinstatement of licenses expired for more than 12 
months may be considered upon proper application and 
payment of a thirty dollar ($30.00) fee. Applicants must 
satisfy the Commission that they possess the current knowl- 
edge, skills and competence necessary to function in the real 
estate business in a manner that protects and serves the 
public interest. In this regard, the Commission may require 
such applicants to complete real estate education and/or pass 
the license examination. 

Statutory Authority G.S. 93A-3(c); 93A-4(c),(d); 93A-4A. 

.0506 SALESMAN TO BE SUPERVISED BY 
BROKER 

(a) A salesman' s license is valid salesman may engage in 
or hold himself out as engaging in activities requiring a real 
estate license only while his license is on active status and 
he is supervised by the broker-in-charge of the real estate 
firm or office where the salesman is engaged in tho business 
of a sal eo man associated . A salesman shall not act as or 
hold himself out to b e a brok e r, nor shall he aot as a 
oal e oman outrid e th e sup e rvision of th e brok e r in charg e of 
tho firm or office whore tho salesman is employed. 

(b) Upon a salesman's association with a real estate 
broker or brokerage firm, the salesman and the broker-in- 
charge of the office where the salesman will be engaged in 
the real estate business of a real estate salesman shall 
immediately file with the Commission a salesman supervi- 
sion notification on a form prescribed by the Commission 
containing th e sal e oman'o nam e and r e sid e nc e address, th e 
name of identifying information about the salesman and the 
broker-in-charge, tho name of tho firm and tho address of 
th e offic e with which th e broker in ohargo is associated, a 
statement from the broker-in-charge certifying that he will 
supervise the salesman in the performance of all acts for 
which a license is required, the date that the broker-in- 
charge assumes responsibility for such supervision, and the 
signatures of the salesman and broker-in-charge. If the 
salesman is on inactive status at the time of associating with 
a broker or brokerage firm, the salesman and broker-in- 
charge shall also file, along with the salesman supervision 



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PROPOSED RULES 



notification, the salesman's request for license activation on 
a form prescribed by the Commission containing identifying 
information about the salesman, a list of Commission- 
approved continuing education courses completed by the 
salesman within the previous 30 days, the salesman's 
statement that he has satisfied the continuing education 
requirements prescribed by Rule .1703 of this Subchapter, 
the date of the request, and the signatures of the salesman 
and the salesman's proposed broker-in-charge. Upon 
mailing or delivering the properly oompl e tod form to th e 
Commiooion by the broker in oharg e , th e salesman named 
in the form may engage in the businooa of a salesman under 
the supervision of the broker in charge ponding acknowlodg 
m e rit from th e Commiosion of reo e ipt of auoh form; how - 
e ver, in th e e v e nt suoh written acknowl e dgm e nt from th e 



the broker-in-charge. 

Statutory Authority G.S. 93A-2(b); 93A-3(c). 

SECTION .1700 - MANDATORY 
CONTINUING EDUCATION 

.1703 CONTINUING EDUCATION FOR 
LICENSE ACTIVATION 

(a) On and aft e r July 1, 19 9 5, a A broker or salesman 
requesting to change an inactive license to active status on 
or after the licensee's second license renewal following his 
initial licensure shall be required to demonstrate completion 
of continuing education as described in th i n Rul e . — The 
licensee must hav e oompletod, oinoe the beginning of th e 



Commission is not received by the broke r in charge within license period immediately preceding the date of request for 



thirty calendar days following the date shown in the form, 
th e brok e r in oharge shall oauoe th e sal e sman to imm e diately 
cease any furth e r aotivity for whioh a real estat e lio e no e is 
required ponding receipt of the written acknowledgment 
from the Commissio Br Upon the mailing or delivery of the 
required formfs) by. the broker-in-charge. the salesman may 
engage in real estate brokerage activities requiring a license 
under the supervision of the broker-in-charge ; however, if 
the salesman and broker-in-charge do not receive from the 
Commission a written acknowledgment of the salesman 
supervision notification and, if a ppropriate, the request for 
license activation, within 30 days of the date shown on the 
form, the broker-in-charge shall immediately terminate the 
salesman's real estate brokerage activities pending receipt of 
the written acknowledgment from the Commission. If the 
salesman and broker-in-charge are notified that the salesman 
is not eligible for license activation due to a continuing 
education deficiency, the broker-in-charge shall cause the 
salesman to immediately cease all activities requiring a real 
estate license until such time as the continuing education 
deficiency is satisfied and a new salesman supervision 
notification and request for license activation is submitted to 
the Commission. 

(c) A broker-in-charge who certifies to the Commission 
that he will supervise a licensed salesman shall actively and 
personally supervise the salesman in a manner which would 
r e a s onabl e aoour e reasonably assures that the salesman 
performs all acts for which a real estate license is required 
in accordance with the real estate license law Real Estate 
License Law and Commission rules. A supervising broker 
who fails to supervise a salesman as prescribed in this Rule 
may be subject to disciplinary action by the Commission. 

(d) Upon termination of his supervision of a salesman, a 
broker-in-charge shall immediately: 

(1) notify the Commission in writing setting forth 
the date of termination; and 

(2) give the salesman, in a form prescribed by the 
Commission, an accurate written statement 
regarding the number and type of properties 
listed, sold, bought, leased or rented for others 
by the salesman while under the supervision of 



licen s e activation, both a mandato r y update course and a 
numb e r of hours in approved elective ooureee to b e deter 
min e d according to Paragraph (b) or (c) of this Rule, 
whichever is appropriate. 

(b) If the mandatory update course was completed during 
th e imm e diat e pr e c e ding l i o e no e period, the licensee must 
also have obtained, einoe tho beginning of the imm e diate 
preceding license period, four credit hour s in app r oved 
elective courses for oach license period or portion thereof 
that the license has boon continuously inaotiv e , up to a 
maximum of 12 hours. — None of th e electiv e cours e or e dit 
hours obtained to satisfy this requirement may bo credited 
toward tho continuing education requirement for tho current 
license p e riod. 

£b) If the inactive licensee's license has properly been on 
active status at any time since the preceding July j^ the 
licensee is considered to be current with regard to continu- 
ing education and no additional continuing education is 
required to activate the license. 

(c) If tho mandatory update course was completed during 
tho current license period, tho licensee must also have 
obtain e d, oino e th e b e ginning of th e imm e diate pr e c e ding 
lio e no e p e riod, — four or e dit hours in approv e d e l e ctiv e 
courses fo r each license period o r portion thereof that tho 
license has boon continuously inactive, up to a maximum of 
16 houro. provid e d that th e minimum number of elective 
cours e or e dit hours r e quir e d oino e th e b e ginning of th e 
immediate preceding license period shall bo eight hours. 
None of those elective course credit hours may bo credited 
toward th e oontinuing e ducation r e quir e ment for th e ourr e nt 
lioenoe period; however, tho update course oredit hours shall 
bo cred i ted toward tho continuing education requirement for 
tho current license period. 

(c) If the inactive licensee's license has not been on active 
status since the preceding July 1. the licensee must make up 
any deficiency in his continuing education record for the 
previous two license periods. Any deficiency may be made 
up by completing, during the current license period, 
approved continuing education elective courses; however, 
such courses will not be credited toward the continuing 
education requirement for the current license period. In 



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160 



PROPOSED RULES 



addition, if the licensee's deficiency included the mandatory 
update course for the immediate preceding license period, 
the licensee must also complete, during the current license 
period, the mandatory update course for the current license 
period; however, such course shall be credited toward the 
continuing education requirement for the current license 
period. Regardless of the length of time a license has been 
on inactive status, the maximum amount of continuing 
education credit hours required to activate that license shall 
be 20 hours. When crediting elective courses for purposes 
of making up a continuing education deficiency, the maxi- 
mum number of credit hours that will be awarded for any 
course is four hours. 

(d) For th e purpoo e of oatiofying tho olootivo ooureo cr e dit 
hour r e quir e m e nt dooorib e d in Paragraphs (b) and (o) of this 
Rulo, tho maximum number of orodit hours that shall bo 
awarded for any s ingle course is four hours. 

Statutory Authority G.S. 93A-3(c); 93A-4A. 

.1707 ELECTIVE COURSE CARRY-OVER 
CREDIT 

If a lioono ee — fully oatiofioo the continu i ng e duoation 
elective? requirement for a particular license period and then 
take s on additional approved continuing education elective 
oouroo(B) in that same lioono e period, th e oreditable houro 
tak e n in th e additional oouro e fo) may b e appli e d toward 
satisfaction of tho continuing eduoation elective r equirement 
for the next succeeding license period. A maximum of four 
hours of continuing education credit for an a pproved elective 
course taken during the current license period may be 
carried over to satisfy the continuing education elective 
requirement for the next following license period if the 
licensee receives no continuing education elective credit for 
the course toward the elective requirement for the current 
license period or the previous license period. However, if 
a continuing education elective course is used to wholly or 
partially satisfy the elective requirement for a part i cu l ar the 
current or previous license period, then any excess hours 
completed in such course which are not needed to satisfy the 
four-hour elective requirement for that license period may 
not be carried forward and applied toward the elective 
requirement for the next ouooocding following license 
period. 

Statutory Authority G.S. 93A-3(c); 93A-4A. 

.1708 EQUIVALENT CREDIT 

(a) A licensee may request that the Commission award 
continuing education credit for a course taken by the 
licensee that is not approved by the Commission, or for 
some other real estate education activity, by making such 
request on a form prescribed by the Commission and 
submitting a nonrefundable evaluation fee of fifty thirty 
dollars ($50.00) ($30.00) for each request for evaluation of 
a course or real estate education activity. Such requests and 
all supporting documents, with the exception of applications 
from instructors of continuing education courses desiring 



equivalent credit for teaching Commission-approved continu- 
ing education courses, must be received by the Commission 
at least 60 days prior to the expiration of the licensee's 
current license. 

(b) The Commission may award continuing education 
elective credit for satisfactory completion of an unapproved 
course which the Commission finds equivalent to the 
elective course component of the continuing education 
requirement set forth in Section .0300 of Subchapter 58E. 
Completion of an unapproved course may serve only to 
satisfy the elective requirement and cannot be substituted for 
completion of the mandatory update course. 

(c) Real estate education activities, other than teaching a 
Commission-approved course, which may be eligible for 
credit include, but are not limited to: developing a 
Commission-approved elective continuing education course, 
authorship of a published real estate textbook; and author- 
ship of a scholarly article, on a topic acceptable for continu- 
ing education purposes, which has been published in a 
professional journal. Each activity for which continuing 
education credit is requested must have been completed 
within the current license period. The Commission may 
award continuing education elective credit for activities 
which the Commission finds equivalent to the elective 
course component of the continuing education requirement 
set forth in Section .0300 of Subchapter 58E. No activity 
other than teaching a Commission-developed mandatory 
update course shall be considered equivalent to completing 
the mandatory update course. 

(d) The Commission may award credit for teaching the 
Commission-developed mandatory update course and for 
teaching an approved elective course. Credit for teaching 
an approved elective course shall be awarded only for the 
license period in which the instructor teaches the course for 
the first time. Credit for teaching a Commission-developed 
mandatory update course may be awarded for each licensing 
period in which the instructor teaches the course. The 
amount of credit awarded to the instructor of an approved 
continuing education course shall be the same as the amount 
of credit earned by a licensee who completes the course. 
The instructor must provide proof that he taught the course 
within the current license period. Licensees who are 
instructors of continuing education courses approved by the 
Commission shall not be subject to the fifty thirty dollar 
($50.00) ($30.00) evaluation fee when applying for continu- 
ing education credit for teaching an approved course. No 
credit toward the continuing education requirement shall be 
awarded for teaching a real estate prelicensing course. 

(e) No carry-over credit to a subsequent license period 
shall be awarded for taking an unapproved continuing 
education course or for any real estate education activity 
other than teaching an approved elective course. 

(f) A licensee completing a real estate a ppraisal 
prelicensing. precertification or continuing education course 
a pproved by the North Carolina Appraisal Board may obtain 
real estate continuing education elective credit for such 
course by submitting to the Commission a written request 
for equivalent continuing education elective credit accompa- 



161 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



nied by a nonrefundable processing fee of twenty dollars 
($20. OCT) and a copy of the certificate of course completion 
issued by the course sponsor for submission to the North 
Carolina Appraisal Board. Such appraisal course must have 
been completed during the license period for which the 
request for equivalent credit is made. 

Statutory Authority G.S. 93A-3(c); 93A-4A. 

.1710 DENIAL OR WITHDRAWAL OF 

CONTINUING EDUCATION CREDIT 

(a) The Commission may deny continuing education 
credit claimed by a licensee or reported by a course sponsor 
for a licensee, and may withdraw continuing education 
credit previously awarded by the Commission to a licensee 
upon finding that: 

(1) The licensee or course sponsor provided incor- 
rect or incomplete information to the Commis- 
sion concerning continuing education completed 
by the licensee; 

(2) The licensee failed to comply with either the 
attendance requirement established by Rule 
. 1705 of this Section or the student participation 
standards set forth in Rule .0511 of Subchapter 
58E; or 

(3) The licensee was mistakenly awarded continuing 
education credit due to an administrative error. 

(b) When continuing education credit is denied or 
withdrawn by the Commission under Paragraph (a) of this 
Rule, the licensee remains responsible for satisfying the 
continuing education requirement. However, when an 
administrative error or an incorrect report by a course 
sponsor results in the denial or withdrawal of continuing 
education credit for a licensee, the Commission may, upon 
request of the licensee, grant the licensee an extension of 
time to satisfy the continuing education requirement. 

(c) A licensee who obtains or attempts to obtain continu- 
ing education credit through misrepresentation of fact, 
dishonesty or other improper conduct shall be subject to 
disciplinary action pursuant to G.S. 93A-6. 

Statutory Authority G.S. 93A-3(c); 93A-4A. 



in the state where the course was taken . Crodit for such 
e ducat i on shall bo awarded only upon r e o e ipt of verification 
provid e d by tho licensing ag e ncy in th e l i c e ns ee 's stat e of 
residence or by the official course sponsor that the licen s ee 
has completed tho number of hours of continuing education 
for which th e licensee deoir e o th e Commission to award 
credit. To obtain credit for a continuing education course 
completed in another state and not a pproved by the Commis- 
sion, the licensee must submit a written request for continu- 
ing education credit accompanied by a nonrefundable 
processing fee of twenty dollars ($20.00) per course and 
evidence satisfactory to the Commission that the course was 
completed and that the course was a pproved for continuing 
education credit by the real estate licensing agency in the 
licensee's state of residence or in the state where the course 
was taken. 

(b) When requesting to change an inactive license to 
active status, or when applying for reinstatement of a license 
expired for not more than 12 months, a nonresident broker 
or salesman may take continuing education courses approved 
by the real estate licensing agency in his state of residence 
or another state to fully satisfy the continuing education 
requirements described in Rules .0505 and . 1703 of this 
Subchapter. 

(c) If tho licensing agency in tho licensee's state of 
resid e nce does not approve courses for real estate continuing 
e ducation, or if tho licensee io not lic e ns e d in his stat e of 
residence, tho licensee In addition to the options described 
in Paragraphs (a) and (b) of this Rule for satisfying the 
continuing education requirement, a nonresident licensee 
may request that the Commission award continuing educa- 
tion credit for a course not approved by the Commission or 
for related educational activities as provided in Rule .1708 
of this Section. 

(d) No carry-over credit to a subsequent license period 
shall be awarded for a course taken in another state that has 
not been a pproved by the North Carolina Real Estate 
Commission as an elective course. 

Statutory Authority G.S. 93A-3(c); 93A-4A. 

SUBCHAPTER 58E - REAL ESTATE 
CONTINUING EDUCATION 



.1711 CONTINUING EDUCATION REQUD1ED 
OF NONRESIDENT LICENSEES 

(a) Real estate brokers and salesmen licensed in North 
Carolina but residing in another state at the time they apply 
for license renewal who wish to renew their licenses on 
active status for a license period beginning on or after July 
1, 1995 may fully satisfy the continuing education require- 
ment eith e r by completing^ within one year preceding 
license expiration, either the Commission-prescribed update 
course plus four classroom hours of instruction in original approval will not bo accepted botwoon April 1 and 



SECTION .0100 - UPDATE COURSE 

.0103 APPLICATION FOR ORIGINAL APPROVAL 

An entity seeking original approval to sponsor a 
Commission-developed update course must make application 
on a form prescribed by the Commission. Beginning — m 
1995, auoh applications must b e submitt e d prior to April 1 
or after Juno 30 of any calendar year. — Applications for 



Commission-approved continuing education elective courses 
or by oomploting eight classroom hours of instruction in 
courses approved for continuing education credit by the real 
estate licensing agency in the licensee's state of residence or 



Jun e 30 of any oal e ndar y e ar after 1994. The applicant 
must submit a nonrefundable fee of one hundred dollars 
($100.00) in the form of a certified check , bank check or 
money order payable to the North Carolina Real Estate 



10:2 



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April 17, 1995 



162 



PROPOSED RULES 



Commission; provided, however, that no fee is required if 
the entity making application is a community college, junior 
college, college or university located in this State and 
accredited by the Southern Association of Colleges and 
Schools^ or is an agency of federal, state or local govern- 
ment . An applying entity that is not a resident of North 
Carolina shall also file with the application a consent to 
service of process and pleadings. 

Statutory Authority G.S. 93A-3(c); 93A-4A. 

SECTION .0200 - UPDATE COURSE 
INSTRUCTORS 

.0203 APPLICATION AND CRITERIA FOR 
ORIGINAL APPROVAL 

(a) A person seeking original approval as an update 
course instructor must make application on a form pre- 
scribed by the Commission. B e ginning in 1995, euoh 
applications must bo submitted prior to April 1 or aftor Juno 
30 of any calendar yoar. Applications for original approval 
will not b e aoo e ptod botwoon April 1 and Juno 30 of any 
oalondar yoar aftor 1994. An applicant who is not a resident 
of North Carolina shall also file with the application a 
consent to service of process and pleadings. No application 
fee is required. All required information regarding the 
applicant's qualifications must be submitted. 

(b) The applicant must be truthful, honest and of high 
integrity. 

(c) The applicant must be qualified under one of the 
following standards: 

(1) Possession of a baccalaureate or higher degree 
with a major in the field of real estate. 

(2) Possession of a current North Carolina real 
estate broker license, three years active full-time 
experience in real estate brokerage within the 
previous ten years, and 30 classroom hours of 
real estate education, excluding prelicensing 
education, within the past three years, such 
education covering topics which are acceptable 
under Commission rules for continuing education 
credit. 

(3) Possession of a current North Carolina real 
estate broker license and experience teaching at 
least ten real estate prelicensing courses within 
the previous five years. 

(4) Possession of a license to practice law in North 
Carolina and three years experience in law 
practice within the previous 10 years, with a 
substantial emphasis on real estate practice. 

(5) Possession of qualifications found by the Com- 
mission to be equivalent to one or more of the 
above standards,^ provided that the requirement 
for a current North Carolina real estate broker 
license shall be waived only for applicants who 
qualify under Subparagraph (eld) or £4} of this 
Rule . 

(d) The applicant must possess good teaching skills as 



demonstrated on a videotape portraying the instructor 
teaching a live audience. The applicant must submit for 
Commission review a videotape in a format prescribed by 
the Commission. The videotape must be 45-60 minutes in 
length and must depict a continuous block of instruction on 
a single real estate or directly related topic. The videotape 
must be unedited, must show at least a portion of the 
audience, and must have visual and sound quality sufficient 
to enable reviewers to clearly see and hear the instructor. 
The videotape must have been made within the previous 
three years. The videotape must demonstrate that the 
instructor possesses the teaching skills described in Rule 
.0509 of this Subchapter. 

(e) An applicant shall be exempt from qualifying under 
Paragraphs (c) and (d) of this Rule if he possesses a current 
North Carolina real estate broker license and a current 
designation as a Designated Real Estate Instructor (DREI) 
granted by the Real Estate Educators Association. 

Statutory Authority G.S. 93A-3(c); 93A-4A. 

.0204 RENEWAL OF APPROVAL 

Commission approval of update course instructors expires 
on the next December 31 following issuance of approval, 
except that approval of instructors approved prior to January 
1, 1995 shall expire on December 31, 1995. In order to 
assure continuous approval, a pproved instructors must file 
applications for renewal of approval must bo filed on a form 
prescribed by the Commission on or before December 1 
immediately preceding expiration of their approval. 
Applicants must satisfy the criteria for original approval, 
with the exception of the requirement stated in Rule 
.0203(d) of this Section, in order to renew their approval. 

Statutory Authority G.S. 93A-3(c); 93A-4A. 

SECTION .0300 - ELECTIVE COURSES 

.0303 APPLICATION FOR ORIGINAL 
APPROVAL 

An entity seeking original approval of a proposed elective 
course must make application on a form prescribed by the 
Commission. Beginning in 19 9 5, ouoh applications must b e 
submitted prior to April 1 or aftor Jun e 30 of any oalondar 
year. Applications for original approval will not be ac- 
cepted between April 1 and June 30 of any calendar year^ 
provided that this restriction shall not app ly when an 
a pplicant is seeking approval to conduct a course for which 
a pproval has already been obtained by another sponsor, after 
1994. The applicant must submit a nonrefundable fee of 
one hundred dollars ($100.00) per course in the form of a 
certified check , bank chock or money ordo* payable to the 
North Carolina Real Estate Commission; provided, how- 
ever, that no fee is required if the entity making application 
is a community college, junior college, college or university 
located in this State and accredited by the Southern Associa- 
tion of Colleges and School or is an agency of federal, 
state or local government . The application shall be accom- 



163 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



I 



* 



panied by a copy of the course plan or instructor's guide for 
the course and a copy of materials that will be provided to 
students. An applying entity that is not a resident of North 
Carolina shall also file with the application a consent to 
service of process and pleadings. 

Statutory Authority G.S. 93A-3(c); 93A-4A. 

.0304 CRITERIA FOR ELECTIVE COURSE 
APPROVAL 

The following requirements must be satisfied in order to 
obtain approval of a proposed elective course: 

(1) The applicant must submit all information required 
by the Commission and pay the application fee, if 
applicable. 

(2) The applicant must satisfy any of the requirements 
of Section .0400 of this Subchapter relating to the 
qualifications or eligibility of course sponsors. 

(3) The subject matter of the course must satisfy the 
elective course subject matter requirements set 
forth in Rule .0305 of this Section and all infor- 
mation to be presented in the course must be 
current and accurate. 

(4) The course must involve a minimum of two 
classroom hours of instruction on acceptable 
subject matter. A classroom hour consists of 50 
minutes of instruction and 10 minutes of break 
time. 

(5) The applicant and the continuing education coordi- 
nator required by Rule .0405 of this Subchapter 
must be truthful, honest and of high integrity. In 
this regard, the Commission may consider the 
reputation and character of any owner, officer and 
director of any corporation, association or organi- 
zation applying for sponsor approval. 

(6) The proposed instructors) for the course must 
possess the qualifications described in Rule .0306 
of this Section. 

(7) The course must be one that will be conducted by 
a qualified instructor who will be able to interact 
directly either in person or by interactive televi- 
sion with all students at all times during the 
course. The course may be conducted through the 
use of interactive television which permits continu- 
ous mutual communication between the instructor 
and all students, continuous observation of the 
instructor by all students, and continuous observa- 
tion of all students by the instructor. The use of 
media-based instruction such as videotape, remote 
non-interactive television, computer programs or 
similar types of instruction may be employed on a 
limited basis to enhance or supplement personal 
instruction. No portion of the course may consist 
of correspondence instruction. 

(8) Th e oouro e plan or instruotor'o guid e muot provide 
for the uso of instructional methods and instruo 
tional aids that are appropriate in view of the 



subject matter and must clearly identify the loam 
tag objootiv e o for th e oouro e . The a pplicant must 
submit an instructor guide that includes: 

(a) a detailed course outline. 

(b) the amount of time to be devoted to each major 
topic and to breaks. 

(c) the learning objective(s) for each major topic, 
and 

(d) the instructional methods and instructional aids 
that will be utilized in the course. 

The proposed time allotments must be appropriate 
for the proposed subject matter to be taught. 
Unless the a pplicant can demonstrate that straight 
lecture is the most effective instructional method 
for the course, the instructor guide must provide 
for the use of an a ppropriate variety of instruc- 
tional methods and instructional aids intended to 
enhance student attentiveness and learning. 
Examples of instructional methods and instruc- 
tional aids that may be appropriate include, but 
are not limited to, class discussion, role-playing, 
in-class work assignments, overhead transparen- 
cies and videotape. 
(9) The course must include handout materials for 
students unless the applicant can demonstrate that 
such materials are either inappropriate or unneces- 
sary for the course. Such materials must ad e 
quatoly oovor the topics described in the course 
plan or in s tructor's guide and must be current, 
accurate, grammatically correct, logically orga- 
nized and produced in a manner that reflects 
reasonable quality. 

(10) Either the instructor guide or the student materials 
must describe, in narrative form, the details of the 
substantive information to be presented in the 
course. The substantive information to be pre- 
sented must be provided in sufficient detail to 
demonstrate that the information is current, accu- 
rate, complete, and otherwise a ppropriate. 

(11) If an a pplicant proposes to use copyrighted materi- 
als in the course, such materials must be used in 
a form approved by the copyright holder. If any 
copyrighted material is to be duplicated by the 
applicant for use in the course, the sponsor must 
have the specific permission of the copyright 
holder. 

Statutory Authority G.S. 93A-3(c); 93A-4A. 

.0305 ELECTIVE COURSE SUBJECT MATTER 

(a) Elective courses must cover a real estate topic and 
must directly contribute to accomplishment of the primary 
purpose of mandatory continuing education, which is to help 
assure that real estate licensees possess the knowledge, skills 
and competence necessary to function in the real estate 
business in a manner that protects and serves the public 
interest. The knowledge or skills taught in an elective 



10:2 



NORTH CAROLINA REGISTER 



April 17, 1995 



164 



PROPOSED RULES 



course must enable licensees to better serve real estate 
consumers and the subject matter must be directly related to 
real estate practice. Examples of acceptable subject matter 
include, but are not limited to: Real property law; agency 
law; real estate contracts; land use controls; environmental 
protection laws; real estate economics and markets; real 
estate finance, investment or appraisal; property manage- 
ment; real estate construction or development; commercial 
real estate brokerage; taxation of real estate investments; the 
Real Estate License Law and Commission rules; and other 
similar topics. Examples of subject matter that is not 
acceptable include, but are not limited to: Real estate sales 
training; real estate brokerage management; business 
administration or management; general office and computer 
skills; success training; motivational training; personal 
development; time management; and other similar topics. 
(b) If there are unique North Carolina laws, rules or 
customary practices that are relevant to a topic being 
addressed in an elective course, and if the course is to be 
conducted in North Carolina or primarily for the benefit of 
North Carolina licensees, then the course must accurately 
and completely address such North Carolina laws, rules or 
practices. 

Statutory Authority G.S. 93A-3(c); 93A-4A. 

SECTION .0400 - GENERAL 
SPONSOR REQUIREMENT 

.0406 COURSE ROSTERS, COMPLETION 
CERTIFICATES AND EVALUATIONS 

(a) Course sponsors and instructors must complete ef 
have students complete, as appropriate, a roster of all real 
estate licensees enrolled in an approved continuing education 
course and a course completion eafd report for each licensee 
who satisfactorily completes the course according to the 
criteria in 21 NCAC 58A . 1705 and who desires continuing 
education credit for the course. Sponsors may allow 
students to complete portions of the course completion 
report, but sponsors will be held accountable for the 
accuracy of all information on such report . Sponsors must 
submit these documents to the Commission within fifteen 
calendar days following the course, but in no case later than 
June 15 for courses conducted prior to that date. These 
documents shall be completed on forms and in accordance 
with instructions prescribed by the Commission. 

(b) Course sponsors and instructors must provide licens- 
ees enrolled in each continuing education course an opportu- 
nity to complete an evaluation of each approved continuing 
education course: — Th e e valuation shal l b e oompl e t e d on a 
form and in accordance with instructions prescribed by the 
Commission. Sponsors must submit the completed evalua- 
tion forms to the Commission within fifteen calendar days 
following the course, but in no case later than June 15 for 
any course completed prior to that date. 

(c) Course sponsors and instructors shall provide each 
licensee who satisfactorily completes an approved continuing 
education course according to the criteria in 21 NCAC 58 A 



.1705 a course completion certificate on a form and in 
accordance with instructions prescribed by the Commission. 
Sponsors must provide the certificates to licensees within 
fifteen calendar days following the course, but in no case 
later than June 15 for any course completed prior to that 
date. The certificate is to be retained by the licensee as his 
proof of having completed the course. 

(d) Course sponsors shall advise the Commission in 
writing when a licensee in attendance at a continuing 
education course does not comply with the Commission's 
attendance or student participation standards. 

Statutory Authority G.S. 93A-3(c); 93A-4A. 

.0407 PER STUDENT FEE 

Following completion of any approved continuing educa- 
tion update or elective course, the sponsor must submit to 
the Commission, along with the roster, course completion 
oardc reports and evaluation forms required to be submitted 
by Rule .0406 of this Section, a fee in the amount of five 
dollars ($5.00) for each licensee who satisfactorily com- 
pletes the course according to the criteria in 21 NCAC 58 A 
. 1705. This fee is not required if the sponsor is a commu- 
nity college, junior college, college or university located in 
North Carolina and accredited by the Southern Association 
of Colleges and Schools.! or is an agency of federal, state or 
local government . This fee shall be paid by check payable 
to the North Carolina Real Estate Commission. A separate 
check is required for each separate class session. 

Statutory Authority G.S. 93A-3(c); 93A-4A. 

SECTION .0500 - COURSE OPERATIONAL 
REQWREMENTS 

.0506 CLASSES OPEN TO ALL LICENSEES 

All class sessions of approved continuing education 
courses must be open to all licensees on a first-come/first- 
served basisi provided that the sponsor of a course which 
has a bona fide education or experience prerequisite, such 
as an advanced course leading to a special real estate 
designation, may refuse admission to a licensee not satisfy- 
ing such prerequisite . Real e stat e lio e noooo, compani e s, 
franchi s es, company owned schools or trade organizations 
approved by the Commiaflion as course sponsors must afford 
all lio e noooo an equal opportunity to e nroll in oaoh ooooion 
of an approv e d oouro e . — Couro e o may not b e promot e d or 
conducted in ouch a manner as would effectively oxoludo 
lioonBoofl who aye not affiliated in some manner with the 
oponoor. An a pproved sponsor may contract with an 
organization such as a real estate firm, franchise or trade 
organization to conduct approved continuing education 
courses for licensees affiliated with such organization, but 
the sponsor must allow licensees not affiliated with the 
organization to enroll in any class session on a first- 
come/first-served basis. 

Statutory Authority G.S. 93A-3(c); 93A-4A. 



165 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



PROPOSED RULES 



.0515 ACCOMMODATIONS FOR PERSONS 
WITH DISABILITIES 

Course sponsors may deviate from Commission rules 
concerning the conduct of continuing education courses, 
such as rules addressing classroom facilities, minimum class 
size and instructional methods, as may be necessary in order 
for the sponsor to comply with the Americans with Disabili- 
ties Act or other laws requiring such sponsors to accommo- 
date persons with disabilities. A sponsor providing a special 
accommodation for a licensee with a disability that requires 
the sponsor to deviate from Commission rules shall notify 
the Commission in writing of the accommodation at the time 
reports are submitted for the class session attended by the 
licensee. 

Statutory Authority G.S. 93A-3(c); 93A-4A. 



I 



I 



10:2 NORTH CAROLINA REGISTER April 17, 1995 166 



LIST OF RULES CODIFIED 



J. he List of Rules Codified is a listing of rules that were filed with OAH in the month indicated. 


Key 




Citation 


= Title, Chapter, Subchapter and Rule(s) 


AD 


= Adopt 


AM 


= Amend 


RP 


= Repeal 


With Chgs 


■=■ Final text differs from proposed text 


Corr 


— Typographical errors or changes that requires no rulemaking 


Eff. Date 


= Date rule becomes effective 


Temp. Expires 


= Rule was filed as a temporary rule and expires on this date or 180 days 



NORTH CAROLINA ADMINISTRATIVE CODE 
MARCH 95 



t 



[TLE 


DEPARTMENT 


10 


Human Resources 


11 


Insurance 


12 


Justice 


13 


Labor 


15A 


Environment, Health, and 




Natural Resources 


17 


Revenue 



[TLE 


DEPARTMENT 


19A 


Transportation 


21 


Occupational Licensing Boards 




14 - Cosmetic Art Examiners 




18 - Electrical Contractors 


25 


Personnel 


26 


Administrative Hearings 


27 


State Bar 



Citation 


AD 


AM 


RP 


With 
Chgs 


Corr 


Eff. 
Date 


Temp. 
Expires 


10 NCAC 3K .0101 - .0104 


/ 






/ 




04/01/95 




3R .3001 




/ 




/ 




04/01/95 




.3020 




/ 




• 




04/01/95 




.3030 




/ 




/ 




04/01/95 




.3032 




/ 




/ 




04/01/95 




.3040 




/ 




/ 




04/01/95 




.3050 




/ 




/ 




04/01/95 




3U .1001 




/ 




/ 




07/01/95 




11 NCAC 1 .0413 




/ 








04/01/95 




4 .0123 - .0124 


/ 






/ 




04/01/95 




.0432 - .0433 


/ 






/ 




04/01/95 




12 .1001 






/ 






04/01/95 




.1024 




/ 








04/01/95 




16 .0601 - .0602 


/ 






/ 




04/01/95 







♦ 



♦ 



167 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 









LIST OF RULES CODIFIED 










Citation 


AD 


AM 


RP 


With 
Chgs 


Corr 


Eff. 
Date 


Temp. 
Expires 


11 


NCAC 16 


.0603 - .0606 


/ 










04/01/95 




.0607 


/ 






/ 




04/01/95 




12 


NCAC 7D 


.0113 


• 










04/01/95 




13 


NCAC 7F 


.0101 




• 








04/01/95 




.0301 




• 








04/01/95 




15A 


NCAC 2D 


.0105 


/ 






/ 




04/01/95 




.0955 - .0957 


/ 






/ 




05/01/95 




.1201 - .1203 




/ 








04/01/95 




.1204 




/ 




/ 




04/01/95 




.1205 




• 








04/01/95 




.1206 




/ 




• 




04/01/95 




.1209 




/ 




• 




04/01/95 




.1401 - .1412 


/ 






/ 




04/01/95 




.1413 


/ 










04/01/95 




.1414 


/ 






• 




04/01/95 




.1415 


/ 










04/01/95 




.1501 


• 






• 




04/01/95 




.1502 


• 










04/01/95 




.1503 


/ 






/ 




04/01/95 




.1504 


/ 










04/01/95 




.1601 


/ 






/ 




04/01/95 




.1602 


/ 










04/01/95 




.1603 


/ 






/ 




04/01/95 






2K 


.0501 - .0503 




• 




• 




04/01/95 






7H 


.0104 




/ 




/ 




04/01/95 




.0309 




/ 








04/01/95 




.0406 




/ 




/ 




04/01/95 






7J 


.0403 




• 




/ 




04/01/95 




.0404 




/ 








04/01/95 






12K 


.0101 


/ 










04/01/95 




.0102 - .0106 


/ 






• 




04/01/95 




.0107 - .0108 


/ 










04/01/95 




.0109 - .0111 


/ 






• 




04/01/95 







70:2 



NORTH CAROLINA REGISTER 



April 17, 1995 



168 



LIST OF RULES CODIFIED 





Citation 


AD 


AM 


RP 


With 
Chgs 


Corr 


Eff. 
Date 


Temp. 
Expires 


15A NCAC 13A .0012 




• 








04/01/95 




16A .0104 




/ 




/ 




04/01/95 




.0107 




/ 








04/01/95 




.0109 




• 




/ 




04/01/95 




18A .3201 - .3202 


/ 






/ 




04/01/95 




.3203 


/ 










04/01/95 




.3204 - .3211 


• 






• 




04/01/95 




.3212 


/ 










04/01/95 




24A .0202 




• 








04/01/95 




.0403 




/ 




/ 




04/01/95 




.0405 




/ 




/ 




04/01/95 




17 NCAC 7B .0123 




/ 








04/01/95 




.0707 




/ 








04/01/95 




.1101 




/ 








04/01/95 




.2401 




/ 








04/01/95 




.5436 






• 






04/01/95 




.5437 






/ 






04/01/95 




19A NCAC 5B .0101 




/ 








04/01/95 




21 NCAC 14F .0007 




/ 




• 




04/01/95 




14G .0003 




• 








04/01/95 




141 .0103 




/ 








04/01/95 




14J .0205 




• 




/ 




04/01/95 




18B .0901 




/ 




/ 




04/01/95 




25 NCAC IE .0902 




/ 




/ 




04/01/95 




26 NCAC 2A .0102 




/ 








04/01/95 




2B .0104 




/ 




/ 




04/01/95 




27 NCAC IB .0105 




/ 








02/20/95 




.0111 - .0112 




/ 








02/20/95 




.0125 




/ 








02/20/95 




ID .0203 










/ 






.0206 




/ 








02/20/95 




.1604 










/ 






2 10.2C0 




• 








02/20/95 







769 



A r 0/?77/ CAROLINA REGISTER 



April 17, 1995 



10:2 



RRC OBJECTIONS 



J. he Rules Review Commission (RRC) objected to the following rules in accordance with G.S. 150B-21.9(a). State 
agencies are required to respond to RRC as provided in G.S. 150B-2 1.12(a). 



ENVIRONMENT, HEALTH, AND NATURAL RESOURCES 

Coastal Management 

15A NCAC 7H .0308 - Specific Use Standards for Ocean Hazard Areas 
ISA NCAC 7M .0202 - Policy Statements 

Environmental Health 

ISA NCAC ISA .2801 - Definitions 

Rule Approved as Written 
ISA NCAC 18A .2810 - Specifications for Kitchens, Based on Number/Children 

Agency Revised Rule 

LICENSING BOARDS AND COMMISSIONS 

Board of Cosmetic Art Examiners 

21 NCAC 14F .0014 - Salon Renewal 

21 NCAC 141 .0401 - App. for Licensure by Individuals Who Have Been Convicted of a Felony 

21 NCAC 141 .0402 - Requests for Preapplication Review of Felony Convictions 

Board of Examiners of Electrical Contractors 

21 NCAC 18B .0901 - Applicants Convicted of Crimes 
No Response from Agency 

Board of Opticians 

21 NCAC 40 .0314 - Apprenticeship and Internship Requirements; Registration 
Agency Revised Rule 
No Response from Agency 
Agency Responded 
No Response from Agency 

PUBLIC EDUCATION 

Elementary and Secondary Education 

16 NCAC 6C .0207 - Prospective Teacher Scholarship Loans 
REVENUE 

Sales and Use Tax 

17 NCAC 7B .1123 - Certain Sales to Commercial Livestock and Poultry Farmers 

17 NCAC 7B .5445 - Commercial Swine, Livestock and Poultry Farmers' Cert. Form: E-599S 

SECRETARY OF STATE 

Notary Public Division 

18 NCAC 7 .0301 - Approved Course of Study 

No Response from Agency 
Rule Returned to Agency 
18 NCAC 7 .0302 - Instructors 
No Response from Agency 
Rule Returned to Agency 



RRC Objection 


03/16/95 


RRC Objection 


03/16/95 


RRC Objection 


01/19/95 


Obj. Removed 


02/16/95 


RRC Objection 


01/19/95 


Obj. Removed 


02/16/95 



RRC Objection 


03/16/95 


RRC Objection 


03/16/95 


RRC Objection 


03/16/95 


RRC Objection 


01/19/95 


Obj. Contd 


02/16/95 


RRC Objection 


11/17/94 


Obj. Contd 


11/17/94 


Obj. Contd 


12/15/94 


Obj. Contd 


01/19/95 


Obj. Contd 


02/16/95 



RRC Objection 02/16/95 



RRC Objection 
RRC Objection 



03/16/95 
03/16/95 



RRC 


Objection 


12/15/94 


Obj. 


Contd 


01/19/95 


Obj. 


Contd 


02/16/95 


RRC 


Objection 


12/15/94 


Obj. 


Contd 


01/19/95 


Obj. 


Contd 


02/16/95 



10:2 



NORTH CAROLINA REGISTER 



April 17, 1995 



170 



CONTESTED CASE DECISIONS 



1 his Section contains the full text of some of the more significant Administrative Law Judge decisions along with an index 
to all recent contested cases decisions which are filed under North Carolina's Administrative Procedure Act. Copies of 
the decisions listed in the index and not published are available upon request for a minimal charge by contacting the 
Office of Administrative Hearings, (919) 733-2698. 



« 



AGENCY 



CASE 
NUMBER 



ALJ 



DATE OF 
DECISION 



PUBLISHED DECISION 
REGISTER CITATION 



ADMINISTRATION 

Division of Purchase and Contract 

Senter-Sanders Tractor Corp. v. Admin., Div of Purchase & Contract 

ALCOHOLIC BEVERAGE CONTROL COMMISSION 

Norman D. Forbes v. Alcoholic Beverage Control Commission 
Albert Stanley Tomanec v. Alcoholic Beverage Control Commission 

CRIME CONTROL AND PUBLIC SAFETY 

Crime Victims Compensation Commission 

John Pavlikianklis v. Victims Compensation Commission 
Wayne L. Utley v. Crime Victims Compensation Commission 
Thomasine Inman v. Crime Victims Compensation Commission 
Irmgard Gordo* v. Crime Victims Compensation Commission 
Ellen Sherwin v. Crime Vic Comp James Byrum Emp/ Baptist Hosp 

ENVIRONMENT, HEALTH, AND NATURAL RESOURCES 

Setzer Bros. Inc. v. Environment, Health, and Natural Resources 
John W. VanHoy, Jr. & Adjacent Land Owners v. EHNR 

and 
Shugart Enterprises, Inc. 



94 DOA 0803 Nesnow 



94 ABC 0787 
94 ABC 1168 



Gray 
Bee ton 



94 CPS 0237 


Morrison 


94 CPS 1180 


Bee ton 


94 CPS 1731 


Nesnow 


94 CPS 1782 


Gray 


95 CPS 0012 


West 



94 EHR 1676 

95 EHR 0016 



Nesnow 
Phipps 



95 EHR 0140 Phipps 



Coastal Resources 

Howard C. Slack v. Coastal Resources Comm, EHNR 

Davidson County Health Department 

John Dee Clodfelter V, Davidson County Health Dept.; EHNR 94 EHR 1037 Chess 

Hyde County Health Department 

Fritzner Henry v. Hyde County Health Department 94 EHR 0924 Gray 

Macon County Health Department 

Four Residents on Genva Circle v. Macon County Health Department 94 EHR 1202 Nesnow 

Maternal and Child Health 

Philip Haakins v. EHNR, Div. of Maternal & Child Health 94 EHR 1777 Chess 

EQUAL EMPLOYMENT OPPORTUNITY 

Marsha Dianne McKoy v. DHR, Div. of MH/DD/SAS, Caswell Center 94 EEO 0379 Chess 

HUMAN RESOURCES 

Helen J. Walls, D/B/A Walls Young World v. Human Resources 94 DHR 1362 Becton 



03/06/95 



03/17/95 
03/07/95 



03/21/95 
03/07/95 
03/09/95 
03/09/95 
03/22/95 



03/09/95 
03/17/95 



03/22/95 



03/13/95 



03/09/95 



03/27/95 



03/09/95 



02/21/95 



03/20/95 



10:2 NCR 176 



i 



10:2 NCR 186 



♦ 



171 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



CONTESTED CASE DECISIONS 



AGENCY 



CASE 
NUMBER 



ALJ 



DATE OF 
DECISION 



PUBLISHED DECISION 
REGISTER CITATION 



Division of Child Development 

Iola Malloy v. DHR, Division of Child Development 
Esther Elder v. DHR, Division of Child Development 



94 DHR 0849 
94 DHR 1771 



Mann 
Reilly 



03/03/95 
03/17/95 



Facility Services 

William H. Cooke v. DHR, Division of Facility Services 
Mildred Reece, Calvin Reece v. DHR, Division of Facility Svcs, 
Domiciliary & Group Care Section 



94 DHR 0565 
94 DHR 1783 



Certificate of Need Section 

Retirement Villages, Inc. (Lessor), and Liberty Healthcare Ltd. 94 DHR 0403 

Partnership (Lessee) D/B/A Countryside Villa of Duplin v. DHR, 
Division of Facility Services, Certificate of Need Section 

and 
Beaver Properties/Wallace, Inc., and Brian Center Health & Retirement/ 
Wallace, Inc. 



Gray 
Gray 



Chess 



03/16/95 
03/16/95 



12/14/94 



Division of Social Services 

Child Support Enforcement Section 

Daniel J. Carter v. Department of Human Resources 

Shawn Dominic Caldwell v. Department of Human Resources 

William Zonta Thompson v. Department of Human Resources 

Jackie E. Hackney v. Department of Human Resources 

Elbert Quick v. Department of Human Resources 

Clement McMillan v. Department of Human Resources 

James R. Gray v. Department of Human Resources 

Lacy Green, Jr. v. Department of Human Resources 

Edwin A. Clarke v. Department of Human Resources 

Lloyd Lane Speake v. Department of Human Resources 

Henry C. Banks v. Department of Human Resources 

Lucille B. Dutter v. Department of Human Resources 

Gary Jay Stocks v. Department of Human Resources 

Paul E. Strawcutter v. Department of Human Resources 

Cary G. Dannelly v. Department of Human Resources 

Robert G. Baker v. Department of Human Resources 

Timothy Brian Eller v. Department of Human Resources 

Morgan Pate, Jr. v. Department of Human Resources 

Robert E. Dudley, Sr. v. Department of Human Resources 

Julian Lattimore v. Department of Human Resources 

James McFadden v. Department of Human Resources 

Raymond B. Clontz Jr. v. Department of Human Resources 

Ruby Fewell Henry v. Department of Human Resources 

Richard Dill v. Department of Human Resources 

Ted C. Jenkins v. Department of Human Resources 

Anthony J. Gibbons v. Department of Human Resources 

Donald L. Costello Sr. v. Department of Human Resources 

Kelvin L. Lankford v. Department of Human Resources 

Jeffrey Thomas Chambers v. Department of Human Resources 

Robert J. Holden v. Department of Human Resources 

Michael L. Wright v. Department of Human Resources 

Terry S. Gurganus v. Department of Human Resources 

John Napoleon Window Cross Pullium v. Dept of Human Resources 

Michael J. Montroy v. Department of Human Resources 

Dennis L. Moore v. Department of Human Resources 

James Edward Knox, Jr. v. Department of Human Resources 

David House v. Department of Human Resources 

Aqustin S. Sanchez v. Department of Human Resources 

Ricky Ratliff v. Department of Human Resources 

Willie McNeil Jr. v. Department of Human Resources 

Ray Douglas Brickhouse v. Department of Human Resources 

Tyron G. Moore v. Department of Human Resources 

Paul A. Card v. Department of Human Resources 



91 CSE 1103 


Morrison 


03/03/95 


92 CSE 1449 


Reilly 


03/29/95 


92 CSE 1559 


Reilly 


03/29/95 


93 CSE 1088 


Chess 


03/20/95 


93 CSE 1169 


Chess 


03/08/95 


93 CSE 1208 


Chess 


03/08/95 


93 CSE 1268 


Chess 


03/08/95 


93 CSE 1295 


Chess 


03/08/95 


93 CSE 1319 


Chess 


03/08/95 


93 CSE 1451 


Chess 


03/22/95 


93 CSE 1556 


Chess 


03/22/95 


93 CSE 1558 


Chess 


03/13/95 


93 CSE 1652 


Chess 


03/21/95 


93 CSE 1713 


Mann 


03/13/95 


94 CSE 1033 


Nesnow 


03/24/95 


94 CSE 1094 


Chess 


03/06/95 


94 CSE 1119 


Reilly 


03/29/95 


94 CSE 1127 


Mann 


03/20/95 


94 CSE 1 128 


Mann 


03/31/95 


94 CSE 1131 


Reilly 


03/13/95 


94 CSE 1132 


West 


03/14/95 


94 CSE 1149 


Nesnow 


03/03/95 


94 CSE 1 157 


Nesnow 


03/16/95 


94 CSE 1195 


Mann 


03/29/95 


94 CSE 1218 


Gray 


03/15/95 


94 CSE 1219 


Gray 


03/15/95 


94 CSE 1228 


West 


03/17/95 


94 CSE 1229 


West 


03/17/95 


94 CSE 1231 


Nesnow 


03/03/95 


94 CSE 1232 


Nesnow 


03/15/95 


94 CSE 1237 


Gray 


03/15/95 


94 CSE 1239 


Gray 


03/02/95 


94 CSE 1241 


Gray 


03/15/95 


94 CSE 1244 


Morrison 


03/13/95 


94 CSE 1249 


Morrison 


03/02/95 


94 CSE 1254 


Reilly 


03/13/95 


94 CSE 1256 


Reilly 


03/15/95 


94 CSE 1259 


West 


03/06/95 


94 CSE 1261 


West 


03/17/95 


94 CSE 1262 


West 


03/17/95 


94 CSE 1263 


West 


03/17/95 


94 CSE 1264 


West 


03/17/95 


94 CSE 1266 


Nesnow 


03/13/95 



10:2 



NORTH CAROLINA REGISTER 



April 17, 1995 



172 



CONTESTED CASE DECISIONS 



AGENCY 



Darrin Yancey v. Department of Human Resources 

Douglas L. Lucas v. Department of Human Resources 

Gregory D. Simpson v. Department of Human Resources 

Michael Lynn Avery v. Department of Human Resources 

Elvis M. Graham v. Department of Human Resources 

Shawn Fonville v. Department of Human Resources 

Shannon Vanderaa v. Department of Human Resources 

Anthony Murray v. Department of Human Resources 

Tommy L. Burchfield v. Department of Human Resources 

Gregory A. Rodrigues v. Department of Human Resources 

Larry R. Bales v. Department of Human Resources 

Karl Philip Jureen v. Department of Human Resources 

Otis Lewis Jr. v. Department of Human Resources 

Robert F. Catoe Jr. v. Department of Human Resources 

William Anthony Winchester v. Department of Human Resources 

Aaron L. Clark v. Department of Human Resources 

Vincent R. Valles Sr. v. Department of Human Resources 

Gary W. Gibson v. Department of Human Resources 

Mark A. West v. Department of Human Resources 

John E. Bolas Jr. v. Department of Human Resources 

Gary C. Wiggins v. Department of Human Resources 

Rhonnie J. Williams v. Department of Human Resources 

Danny Ray Hensley v. Department of Human Resources 

Ivy M. Harvell v. Department of Human Resources 

Terry L. McMillon v. Department of Human Resources 

Garry G. Hickman v. Department of Human Resources 

Willie Herring v. Department of Human Resources 

Joe C. Dean v. Department of Human Resources 

Jimmic E. Barnes v. Department of Human Resources 

Cecilia Carmosino v. Department of Human Resources 

Marvin F. Walker v. Department of Human Resources 

Richard J. Almeida v. Department of Human Resources 

Michael R. French v. Department of Human Resources 

John A. Jackson v. Department of Human Resources 

Michael R. Roberts v. Department of Human Resources 

Cleothis B. Smith v. Department of Human Resources 

Leroy Johnson Jr. v. Department of Human Resources 

James Patterson v. Department of Human Resources 

Thomas Colon v. Department of Human Resources 

Walter Swirniak Jr. v. Department of Human Resources 

Marion Rodriguez v. Department of Human Resources 

Jerry L. White Sr. v. Department of Human Resources 

Dennis James Grimes v. Department of Human Resources 

Scott John Tozzi v. Department of Human Resources 

Roger A. Eaton v. Department of Human Resources 

Willie J. Flowers Jr. v. Department of Human Resources 

Jeffrey James Spence v. Department of Human Resources 

Byron C. Alston v. Department of Human Resources 

Oliver Lee Wolfe Sr. v. Department of Human Resources 

James Tracy Strickland v. Department of Human Resources 

Michael K. Reese v. Department of Human Resources 

Richard G. Medford, Jr. v. Department of Human Resources 

Theresa Strader v. Department of Human Resources 

James F. Williams v. Department of Human Resources 

Marion A. Ward v. Department of Human Resources 

Robert Lee Wall v. Department of Human Resources 

James M. Breaden Jr. v. Department of Human Resources 

Peter G. Coley v. Department of Human Resources 

Benjamin Nuriddin v. Department of Human Resources 

Robert L. Carter v. Department of Human Resources 

Danny Columbus Baker v. Department of Human Resources 

Duke William Dupre' v. Department of Human Resources 

Audrey Jennings v. Department of Human Resources 

Michael A. Camp v. Department of Human Resources 

Martin J. Miller v. Department of Human Resources 

Willie Cherry, Jr. v. Department of Human Resources 

William V. Glennon v. Department of Human Resources 

Alaster Williams v. Department of Human Resources 



CASE 




DATE OF 


NUMBER 


ALJ 


DECISION 


94 CSE 1269 


Nesnow 


03/15/95 


94 CSE 1270 


Nesnow 


03/15/95 


94 CSE 


1272 


Becton 


03/15/95 


94 CSE 


1274 


Becton 


03/15/95 


94 CSE 


1275 


Becton 


03/15/95 


94 CSE 


1277 


Becton 


03/06/95 


94 CSE 


1286 


Mann 


03/21/95 


94 CSE 


1287 


Mann 


03/21/95 


94 CSE 


1289 


Mann 


03/21/95 


94 CSE 


1300 


Mann 


03/21/95 


94 CSE 


1302 


Gray 


03/02/95 


94 CSE 


1303 


Gray 


03/15/95 


94 CSE 


1314 


Mann 


03/21/95 


94 CSE 


1329 


Morrison 


03/15/95 


94 CSE 


1331 


Reilly 


03/15/95 


94 CSE 


1332 


Reilly 


03/15/95 


94 CSE 


1333 


West 


03/17/95 


94 CSE 


1334 


West 


03/06/95 


94 CSE 1335 


West 


03/17/95 


94 CSE 


1336 


Nesnow 


03/15/95 


94 CSE 1338 


Nesnow 


03/15/95 


94 CSE 1339 


Becton 


03/15/95 


94 CSE 1340 


Becton 


03/15/95 


94 CSE 


1345 


Mann 


03/21/95 


94 CSE 


1346 


Mann 


03/21/95 


94 CSE 


1348 


Gny 


03/15/95 


94 CSE 


1350 


Morrison 


03/02/95 


94 CSE 1351 


Morrison 


03/15/95 


94 CSE 1352 


Reilly 


03/03/95 


94 CSE 


1354 


West 


03/17/95 


94 CSE 


1355 


West 


03/17/95 


94 CSE 


1357 


Nesnow 


03/15/95 


94 CSE 


1359 


Becton 


03/15/95 


94 CSE 


1370 


Mann 


03/07/95 


94 CSE 


1371 


Mann 


03/21/95 


94 CSE 1373 


Gray 


03/15/95 


94 CSE 


1377 


Mann 


03/31/95 


94 CSE 


1378 


Morrison 


03/15/95 


94 CSE 


1379 


Reilly 


03/15/95 


94 CSE 


1382 


West 


03/17/95 


94 CSE 


1385 


Nesnow 


03/03/95 


94 CSE 


1387 


Nesnow 


03/15/95 


94 CSE 


1388 


Becton 


03/15/95 


94 CSE 


1389 


Becton 


03/15/95 


94 CSE 


1392 


Gray 


03/09/95 


94 CSE 


1393 


Morrison 


03/15/95 


94 CSE 


1394 


Reilly 


03/15/95 


94 CSE 


1396 


Nesnow 


03/03/95 


94 CSE 


1397 


Mann 


03/31/95 


94 CSE 


1398 


Mann 


03/31/95 


94 CSE 


1412 


Gray 


03/31/95 


94 CSE 


1415 


Morrison 


03/02/95 


94 CSE 


1416 


MorriBOn 


03/21/95 


94 CSE 


1417 


Morrison 


03/21/95 


94 CSE 


1421 


Reilly 


03/03/95 


94 CSE 1425 


West 


03/31/95 


94 CSE 


1426 


West 


03/31/95 


94 CSE 


1427 


West 


03/31/95 


94 CSE 


1429 


West 


03/31/95 


94 CSE 


1430 


Nesnow 


03/24/95 


94 CSE 


1431 


Nesnow 


03/24/95 


94 CSE 


1432 


Nesnow 


03/24/95 


94 CSE 


1433 


Nesnow 


03/24/95 


94 CSE 


1435 


Becton 


03/06/95 


94 CSE 


1436 


Becton 


03/06/95 


94 CSE 


1439 


Chess 


03/03/95 


94 CSE 


1444 


Mann 


03/07/95 


94 CSE 


1445 


Gray 


03/02/95 



PUBLISHED DECISION 
REGISTER CITATION 



173 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



CONTESTED CASE DECISIONS 



AGENCY 



Henry L. Gibbs v. Department of Human Resources 

Beau L. Miller v. Department of Human Resources 

Elizabeth F. West v. Department of Human Resources 

Lori Davis Humphrey v. Department of Human Resources 

Cyrus R. Luallen v. Department of Human Resources 

Harold Dean Horn v. Department of Human Resources 

James B. Miller v. Department of Human Resources 

Glenn Allison v. Department of Human Resources 

Louis R. Salamone v. Department of Human Resources 

Randy Norris Willis v. Department of Human Resources 

Michael E. Bellamy v. Department of Human Resources 

Eddie James Johnson v. Department of Human Resources 

Co ley C. Matthews v. Department of Human Resources 

Peter Ian Oliveira v. Department of Human Resources 

Ronald E. Lewis v. Department of Human Resources 

Carlos L. Robinson v. Department of Human Resources 

Eddie O. Toro v. Department of Human Resources 

Bruce Kelly Jacobs v. Department of Human Resources 

Tony Collins v. Department of Human Resources 

Marvin B. Harris v. Department of Human Resources 

Dennis Ray Alexander v. Department of Human Resources 

Joseph R. & Linda M. Grooms v. Department of Human Resources 

Robert M. Martin v. Department of Human Resources 

Louis Cragg III v. Department of Human Resources 

Ellen Downing v. Department of Human Resources 

Charles R. Hauley v. Department of Human Resources 

Michael L. Schadlcr v. Department of Human Resources 

Terrencc R. McLaughlin v. Department of Human Resources 

Joel P. Roth v. Department of Human Resources 

At ward T. Warren v. Department of Human Resources 

Roger T. Benoy v. Department of Human Resources 

Kenneth J. Balfour v. Department of Human Resources 

Dennis W. Nolan v. Department of Human Resources 

Randolph J. Nunn v. Department of Human Resources 

David Lester Gordon v. Department of Human Resources 

Jimmy R. Jackson v. Department of Human Resources 

Mark A. Jones v. Department of Human Resources 

Ondino Damota Freitas v. Department of Human Resources 

Nelson Bennett v. Department of Human Resources 

Robert Larry Martin v. Department of Human Resources 

Joseph O. Evans v. Department of Human Resources 

Donald E. Kirby v. Department of Human Resources 

Paul R. Ross v. Department of Human Resources 



CASE 




DATE OF 


PUBLISHED DECISION 


NUMBER 


AU 


DECISION 


REGISTER CITATION 


94 CSE 1446 


Morrison 


03/21/95 




94 CSE 1452 


West 


03/07/95 




94 CSE 1455 


Nesnow 


03/07/95 




94 CSE 1459 


Becton 


03/06/95 




94 CSE 1470 


Mann 


03/31/95 




94 CSE 1471 


Mann 


03/07/95 




94 CSE 1472 


Mann 


03/07/95 




94 CSE 1473 


Gray 


03/02/95 




94 CSE 1474 


Gray 


03/09/95 




94 CSE 1476 


Morrison 


03/21/95 




94 CSE 1477 


Morrison 


03/02/95 




94 CSE 1478 


Morrison 


03/02/95 




94 CSE 1479 


Morrison 


03/21/95 




94 CSE 1489 


Becton 


03/07/95 




94 CSE 1491 


Becton 


03/07/95 




94 CSE 1499 


Mann 


03/31/95 




94 CSE 1500 


Mann 


03/31/95 




94 CSE 1508 


Gray 


03/31/95 




94 CSE 1511 


Gray 


03/02/95 




94 CSE 1533 


Morrison 


03/02/95 




94 CSE 1538 


Reilly 


03/03/95 




94 CSE 1539 


Reilly 


03/07/95 




94 CSE 1541 


Reilly 


03/07/95 




94 CSE 1543 


West 


03/06/95 




94 CSE 1553 


Nesnow 


03/30/95 




94 CSE 1554 


Becton 


03/07/95 




94 CSE 1555 


Becton 


03/07/95 




94 CSE 1569 


Chess 


03/07/95 




94 CSE 1572 


West 


03/14/95 




94 CSE 1573 


West 


03/31/95 




94 CSE 1579 


Reilly 


03/03/95 




94 CSE 1584 


Morrison 


03/07/95 




94 CSE 1590 


Gray 


03/31/95 




94 CSE 1608 


Mann 


03/21/95 




94 CSE 1609 


Mann 


03/13/95 




94 CSE 1648 


Gray 


03/09/95 




94 CSE 1649 


Morrison 


03/07/95 




94 CSE 1650 


Reilly 


03/07/95 




94 CSE 1656 


Gray 


03/02/95 




94 CSE 1750 


Chess 


03/21/95 




94 CSE 1766 


Chess 


03/21/95 




94 CSE 1767 


Reilly 


03/03/95 




94 CSE 1778 


West 


03/06/95 





JUSTICE 



Alarm Systems Licensing Board 

Patrick P. Sassman v. Alarm Systems Licensing Board 

Private Protective Services Board 



94 DOJ 1825 



Reilly 



03/09/95 



Lewis Austin Saintsing v. Private Protective Services Board 
Marcus T. Williams v. Private Protective Services Board 
Melvin Ray Cooper v. Private Protective Services Board 
Donnell E. Morrow, Jr. v. Private Protective Services Board 



94 DOJ 1000 


Chess 


03/03/95 


94 DOJ 1064 


Chess 


02/24/95 


94 DOJ 1635 


Reilly 


03/09/95 


94 DOJ 1823 


Reilly 


03/09/95 



LABOR 



Wage and Hour Division 

R.J. Scott, Pres. Pirate Enterprises, Inc. v. Labor, Wage & Hour Division 94 DOL 1524 

PUBLIC INSTRUCTION 



West 



03/23/95 



Glenn II, on behalf of Glenn II, and Glenn II, Individually v. Charlotte- 93 EDC 0549 Chess 

Mecklenburg County Schools 
William Hewett v. State Board of Education 94 EDC 0533 Gray 



03/16/95 

03/31/95 10:2 NCR 179 



10:2 



NORTH CAROLINA REGISTER 



April 17, 1995 



174 



CONTESTED CASE DECISIONS 



AGENCY 

Bobby G. Little v. Department of Public Instruction 

STATE PERSONNEL 

Caswell County Health Department 

Julie R. Johnson v. Caswell County Health Department 

Department of Correction 

Nancy Gilchrist v. Department of Correction 
Thomas Wayne Smathcrs v. Department of Correction 
Ruth Kearney v. Department of Correction 

Office of ike District Attorney 

Shannon Caudill v. Office of the District Attorney for Judicial 
District 17-B, and Administrative Office of the Courts 

Forsyth Stokes Mental Health Center 

Michael Howell v. Forsyth Stokes Mental Health Center 

Department of Human Resources 

Rebecca Johnson v. Human Resources, Special Care Center 

Cherry Hospital 
William H. Cooke v. DHR, Cherry Hospital 

Iredell County Department of Social Services 

Vemon E. Crosse v. Iredell County Department of Social Services 
Bonnie N. Bellamy v. Iredell County Department of Social Services 



CASE 
NUMBER 



95 EDC 0168 



94 OSP 0865 



95 OSP 0188 



94 OSP 0499 



95 OSP 0138 



93 OSP 1547 



94 OSP 0282 
94 OSP 0739 



ALJ 



Phippe 



Reilly 



Nesnow 



Chess 



West 



Gray 



Bee ton 
Chess 



Lee-Harnett Area Mental Health, Developmental Disabilities, and Substance Abuse Authority 



Julie Dyer v. Lee-Harnett Area MH/DD/SA Authority 

North Carolina State University 

Billy Ray Kelly v. NCSU Physical Plant 

Department of Transportation 

Michael E. Kornegay v. Department of Transportation 

UNC Hospitals 

David Patrick Malone v. Univ. of NC Hospital at Chapel Hill 



94 OSP 0750 



95 OSP 0130 



93 OSP 1700 



94 OSP 0771 



Gray 



West 



Gray 



Becton 



DATE OF 
DECISION 



03/20/95 



PUBLISHED DECISION 
REGISTER CITATION 



03/15/95 



94 OSP 0121 


West 


03/09/95 


94 OSP 0590 


West 


03/23/95 


94 OSP 1807 


Becton 


03/13/95 



03/20/95 



03/24/95 



03/31/95 



03/16/95 



03/09/95 
03/01/95 



03/20/95 



03/22/95 



03/24/95 



03/14/95 



♦ 



10:01 NCR 48 



i 



♦ 



175 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



CONTESTED CASE DECISIONS 



STATE OF NORTH CAROLINA 



COUNTY OF CUMBERLAND 



IN THE OFFICE OF 

ADMINISTRATIVE HEARINGS 

94 CPS 0237 



JOHN PAVLHOAMDIS 
Petitioner, 



N.C. VICTIMS COMPENSATION 
COMMISSION 

Respondent. 



RECOMMENDED DECISION 



Petitioner filed a timely Petition for a Contested Case Hearing with the Office of Administrative Hearings on 
February 22, 1994. 

On March 15, 1995, this contested case came on for hearing by telephone conference with Fred G. Morrison Jr., 
Senior Administrative Law Judge presiding. 

APPEARANCES 

For Petitioner: James H. Cooke, Jr. 

Parish, Cooke and Russ 
P.O. Drawer 1824 
Fayetteville, NC 28302 

For Respondent: Robert T. Hargett 

Assistant Attorney General 
N.C. Department of Justice 
P.O. Box 629 
Raleigh, NC 27602-0629 

STATUTES AT ISSUE 

N.C. Gen. Stat. §§15B-4(a) & 15B-1 1(a)(3) 

ISSUE 
Did the N.C. Crime Victims Compensation Commission properly deny Petitioner's claim? 

FINDINGS OF FACT 

1. Alexandra Pavlikianidis, age 13, daughter of Petitioner, rode her bike to the Honeycutt Recreation area in 
Fayetteville on Sunday, August 30, 1992. 

2. When Alexandra arrived at the park, she stopped to get a drink by the public bathroom. When she stopped, she 
noticed three girls approximately 10 to 13 years of age playing near the area. 

3. When Alexandra was trying to go up some playground equipment stairs after resting, the three girls came running 
down the stairs towards her. During this incident, Alexandra was pushed, shoved, or bumped backwards down the stairs. 
She fell over the handrail and down to the base of the steps. The three girls laughed and ran off after Alexandra had fallen. 

4. There were three women at the scene with their children and two of them rushed over to Alexandra and asked if 
she was okay. She told them that her ankle and foot were hurt. One of the women offered her a ride home. 

5. The other woman went to see where the three girls had gone. The woman yelled for the girls to come back and 



10:2 



NORTH CAROLINA REGISTER 



April 17, 1995 



176 



CONTESTED CASE DECISIONS 



brought the oldest girl back to where Alexandra was. 

6. When Alexandra returned home, her mother took her to the Doctors Urgent Care to have them look at her injuries. 
The doctor put a cast on Alexandra's leg and told her that she might need surgery. He referred her to another doctor. 

7. On August 31, 1992, Petitioner and Alexandra spoke with someone at the Parks and Recreation Department to report 
the incident. They were told to make a report with the police. 

8. Pete Pavlikianidis, Alexandra's uncle, called the police on August 31, 1992, to make a report. They took 
Alexandra's statement over the telephone and then spoke to her father. They asked her if she had reported the incident to 
the Parks and Recreation Department and she told them that she had. 

9. On August 31, 1992, Alexandra spoke to Investigator Tew of the Fayetteville Police Department who took her 
statement and asked her about the report made to the Parks and Recreation Department. Investigator Tew also asked 
Alexandra about the police report she had previously made. Alexandra also spoke to George McCarthy from the Risk 
Management Division of the Parks and Recreation Department. 

10. On August 31, 1992, Alexandra went to see Dr. George Dimitri who told her that she would need surgery on her 
foot. He told her that she had broken four toes and two connective bones in her foot. 

11. On September 2, 1992, Alexandra had surgery on her foot and was out of school for more than two months after 
the surgery. 

12. Alexandra has been required to have continuous follow-up care, including physical therapy, which has caused her 
to miss school. 

13. Petitioner's father filed a claim for compensation with Respondent which was denied. 

14. Pushing and shoving by children playing are facts of life. 

Based upon the foregoing Findings of Fact, the undersigned makes the following: 

CONCLUSIONS OF LAW 

1. The Office of Administrative Hearings has jurisdiction over the parties and subject matter of this contested case 
pursuant to G.S. 150B and 15B. 

2. Subject to the limitations in G.S. 15B-22, 

compensation for criminally injurious conduct shall be awarded to a claimant if substantial evidence 
established that the requirements for an award have been met. . . . 

N.C. Gen. Stat. §15B-4(a) (1994) (emphasis added). 

3. The statute defines "criminally injurious conduct" as: 

(C)onduct which by its nature poses a substantial threat of personal injury or death, and is punishable by 
fine or imprisonment or death, . . . 

N.C. Gen. Stat. §15B-2(5) (1994) (emphasis added). 

4. The evidence is inconclusive as to whether or not Alexandra was injured by criminally injurious conduct, the proof 
of which is a necessary element for the award of compensation. Pushing and shoving by children on a public playground 
does not alone constitute criminal conduct within the purview of G.S. 15B. 

Based upon the foregoing Findings of Fact and Conclusions of Law, the undersigned makes the following: 



177 NORTH CAROLINA REGISTER April 17, 1995 10:2 



CONTESTED CASE DECISIONS 



RECOMMENDED DECISION 

It is recommended that Petitioner's claim for compensation be denied. 

ORDER 

It is hereby ordered that the agency serve a copy of the final decision on the Office of Administrative Hearings, P.O. 
Drawer 27447, Raleigh, N.C. 27611-7447, in accordance with North Carolina General Statute 150B-36(b). 

NOTICE 

The agency making the final decision in this contested case is required to give each party an opportunity to file 
exceptions to this recommended decision and to present written arguments to those in the agency who will make the final 
decision. G.S. 150B-36(a). 

The agency is required by G.S. 150B-36(b) to serve a copy of the final decision on all parties and to furnish a copy 
to the parties' attorney of record and to the Office of Administrative Hearings. 

The agency that will make the final decision in this contested case is the North Carolina Crime Victims 
Compensation Commission. 

This the 21st day of March, 1995. 



Fred G. Morrison Jr. 

Senior Administrative Law Judge 



10:2 NORTH CAROLINA REGISTER April 17, 1995 178 



CONTESTED CASE DECISIONS 



STATE OF NORTH CAROLINA 



COUNTY OF BRUNSWICK 



IN THE OFFICE OF 

ADMINISTRATIVE HEARINGS 

94 EDC 0533 



♦ 



WILLIAM HEWETT, 
Petitioner, 



THE NORTH CAROLINA 
STATE BOARD OF EDUCATION, 
Respondent. 



RECOMMENDED DECISION 



This contested case was heard before Beecher R. Gray, administrative law judge, on October 17 and 18, 1994 in 
Southport, North Carolina. Following receipt of transcripts of the proceeding, Respondent and Petitioner filed proposed 
decisions and written arguments on February 27, 1995 and March 6, 1995, respectively. 

APPEARANCES 

Petitioner: Don W. Viets, Esq. 

Respondent: Barbara A. Shaw, Assistant Attorney 

General, North Carolina Department of Justice. 

EXHIBITS 

Exhibits 1-5 were admitted into evidence 
Offered no exhibits into evidence 

EXPERT WITNESSES 

Thomas Lewis was tendered and accepted as an expert in education. 
Carlton Prince was tendered and accepted as an expert in education. 
Coleman Barbour was tendered and accepted as an expert in education and as a middle school and high 



Respondent: 
Petitioner: 

Petitioner: 

1. 

2. 



i 



3. 
school principal. 

4. Joseph Miller was tendered and accepted as an expert in teaching Health and Physical Education at the high 
school level. 

5. Timothy Fitzgerald was tendered and accepted as an expert in teaching Health, Physical Education, History, 
and Vocational Education. 

Respondent: 

Respondent did not offer any expert testimony. 

ISSUES 

1. Whether Respondent has substantial evidence, sufficient to justify permanent revocation of Petitioner's 

teaching certificate, that Petitioner has been convicted of a crime, as an adult, and that there is a reasonable and adverse 



♦ 



179 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



CONTESTED CASE DECISIONS 



relationship between the underlying crime and his continuing ability to perform any of his professional functions effectively. 

2. Whether Respondent has substantial evidence, sufficient to justify permanent revocation of Petitioner's 

teaching certificate, that Petitioner has engaged in other illegal, unethical, or lascivious conduct and that there is a reasonable 
and adverse relationship between the underlying conduct and his continuing ability to perform any of his professional 
functions effectively. 

FINDINGS OF FACT 

1 . The parties received notice of hearing more than 15 days prior to the hearing and each stipulated on the record that 
notice was proper in all respects. 

2. Petitioner currently holds a teaching certificate issued by the State Board of Education. 

3. Petitioner resides in Brunswick County and did so at the time of the events giving rise to this contested case appeal. 

4. Petitioner was employed by South Brunswick High School (SBHS) in June, 1990 to serve as a teacher, head football 
coach, and athletic director. Petitioner taught health and physical education and remedial math to both males and females 
at SBHS. 

5. Prior to his employment with SBHS, Petitioner worked for a number of years as a teacher and coach in other high 
school systems in both North and South Carolina. 

6. On or about November 17, 1993, Petitioner was suspended from his position with SBHS because of allegations 
arising from November 16, 1993 off-campus encounters between Petitioner and two current female students at SBHS in 
which it was alleged that Petitioner was intoxicated and had touched the breasts of the two students without consent. 
Petitioner did not return to his position and eventually resigned in February, 1994. The allegations against Petitioner were 
investigated by the Brunswick County School Superintendent. The investigation and allegations were covered by the press. 

7. The parties stipulated, and it is found as fact, that Petitioner received a January 27, 1994 document captioned 
FINDING OF REASONABLE CAUSE AND STATEMENT OF CHARGES. The reasonable cause section of this document 
provides, in pertinent part: 

Bob Etheridge, State Superintendent of Public Instruction, having received notice from the Brunswick 
County Schools, finds that: 

[o]n the evening of November 16, 1993, Mr. Hewett appeared intoxicated at two restaurants where female students 
were working, and deliberately touched two current female students on their breasts, following which the students 
filed criminal charges against Mr. Hewett (sic). 



3. While Mr. Hewett denies all allegations except that of being intoxicated on the evening of November 16, 
1993, the superintendent has found there is substantial reason to believe that Mr. Hewitt (sic) has violated 
16 NCAC 6C .0312(b)(8). 

4. The State Board of Education has adopted a rule, codified as 16 NCAC 6C .0312, that governs the 
suspension or revocation of certificates. That rule provides, in part, that the Board may revoke a certificate 
for any illegal, unethical or lascivious conduct by a person if there is a reasonable and adverse relationship 
between the underlying conduct and the continuing ability of the person to perform any of his/her 
professional functions in an effective manner. 

8. In the Statement of Charges section of this January 27, 1994 document, the State Superintendent states in pertinent 

part: 

On the basis of this determination of reasonable cause, the State Superintendent files written charges against Mr. 



10:2 NORTH CAROLINA REGISTER April 17, 1995 180 



CONTESTED CASE DECISIONS 



Hewlett (sic) as follows: 

1 . The Brunswick County school superintendent has reported that he has substantial reason to believe 

that: 

On the evening of November 16, 1993, Mr. Hewett appeared intoxicated at two restaurants where female students 
were working, and deliberately touched two current female students on their breasts, following which the students 
filed criminal charges against Mr. Hewitt (sic). 



2. These actions constitute grounds for the revocation cf his certificate pursuant to 16 NCAC 6C .0312(a)(8) 

and indicate that the certificate should in fact be revoked. 

9. Respondent's rule cited by Superintendent Etheridge as authority for revocation of Petitioner's certificate provides, 
in pertinent part: 

(a) The SBE may deny an application for certification or may suspend or revoke a certificate issued by the 

department only for the following reasons: 

(1) fraud, material misrepresentation or concealment in the application for certification; 

(2) changes in or corrections of the certificate documentation which makes the individual 
ineligible to hold a certificate; 

(3) conviction or entry of a plea of no contest, as an adult, of a crime if there is a reasonable and 
adverse relationship between the underlying crime and the continuing ability of the person to 
perform any of his/her professional functions in an effective manner; 

(4) final dismissal of a person by a local board pursuant to G.S. 115C-325(e)(l)b., if there is a 
reasonable and adverse relationship between the underlying misconduct and the continuing ability 
of the person to perform any of his/her professional functions effectively; 

(5) final dismissal of a person by a LEA under G.S. 115C-325(e)(l)e; 

(6) resignation from employment with a LEA without thirty work days' notice, except with the prior 
consent of the local superintendent; 

(7) revocation of a certificate by another state; and 

(8) any other illegal, unethical or lascivious conduct by a person, if there is a reasonable and adverse 
relationship between the under-lying conduct and the continuing ability of the person to perform 
any of his/her professional functions in an effective manner. 

(9) Failure to report revocable conduct as required under paragraph (b) of this Rule. N.C. Admin. 
Code, tit. 16, r. 6C.03 12(a) (November, 1994). 

10. Respondent contends in this certificate action against Petitioner that it has grounds to revoke his certificate under 
both .0312(a)(3) and .0312(a)(8). 

11. SBHS senior Tina Mount filed a criminal charge against Petitioner on November 27, 1993 for assault on a female 
over 18 years of age by grabbing her breast . This charge was tried before a District Court Judge in Brunswick County on 
June 3, 1994. Petitioner entered a plea of not guilty. The District Court Judge found Petitioner guilty of assault on a female 
over the age of 18 by grabbing her breast in violation of G.S. 14-33(b)(2) as charged. The District Court ordered a prayer 
for judgment continued upon payment of court costs. This is the only charge asserted by Respondent as grounds for 
revocation of Petitioner's Certificate under either its Conviction Rule, .0312(a)(3) or its Conduct Rule, .0312(a)(8). 

12. Tina Mount did not appear and testify in this contested case hearing. 

181 NORTH CAROLINA REGISTER April 17, 1995 10:2 



CONTESTED CASE DECISIONS 



13. Marsha Cochran, guidance counselor at SBHS since 1985 and at the time of the events in this case, observed that 
Tina Mount, who worked in her office as a student mentor, was happy and outgoing prior to November 16, 1993 but 
became nervous and more withdrawn after that date. 

14. Respondent offered no direct evidence of the conduct of Petitioner on the evening of November 16, 1993. 
Respondent asserts that it can imply the underlying conduct by proving that Petitioner received a guilty verdict, with a prayer 
for judgment continued, in the District Court criminal trial. 

15. Petitioner went to a bar/restaurant known as the Shamrock in Southport on the evening of November 16, 1993. 
When he entered the restaurant, Tina Mount was working as a waitress and spoke to him as he entered. Petitioner ordered 
a beer and later ordered a meal. Petitioner had consumed one or more drinks during an earlier visit to the Shamrock that 
evening. Tina Mount sat at his table and talked with Petitioner. He offered to buy a drink for her. She refused because 
she was working. He gave her five dollars with which to buy herself a drink after she finished work. She told him that 
she was a student at SBHS. While she was standing and he was seated, he gave her a hug around the waist. As they walked 
toward the door on his way out, he reached for her arm and touched her breast during the process. Petitioner's 
uncontroverted testimony is that he was reaching for her arm to say thanks and accidentally touched her breast, for which 
he apologized before leaving. 

16. Ralph Ward has been in education for thirty-six years, serving as personnel director of the Brunswick Schools for 
the last seven. He gave a lay opinion under G.S. 8C-1, Rule 701, regarding Petitioner's ability to continue to perform his 
professional functions after being found guilty of assault on a female. Mr. Ward's opinion as personnel director of SBHS 
was that some students would have concerns about their safety and parents would have concerns about their students' safety 
under Petitioner's control. He also believes that Petitioner's return to teaching would raise a concern that another similar 
incident could occur and that morale in the school would be affected negatively. 

17. Thomas Lewis has been in education for thirty-eight years, serving as principal for twenty-eight of those years. 
He was tendered and accepted as an expert witness in education under G.S. 8C-1, Rule 702. Mr. Lewis' expert opinion 
was that Petitioner could continue to be effective as a teacher and coach in some other community but probably not in the 
Brunswick County community. 

18. Carlton Prince has served for thirty years in the Whiteville, North Carolina City Schools, serving as principal for 
the last fifteen before retiring in 1991. Mr. Prince was tendered and accepted as an expert witness in education under G.S. 
8C-1, Rule 702. Petitioner served as a teacher, coach, and athletic director for a number of years at Whiteville while Carlton 
Prince was the principal there. Mr. Prince gave an expert opinion that Petitioner still could effectively function as a teacher, 
coach, athletic director, and role model for students. 

19. Coleman Barbour has been in education for twenty-one years. He presently serves as principal at Whiteville High 
School and was there during part of Petitioner's tenure as a teacher, coach, and athletic director. Mr. Barbour was tendered 
and accepted as an expert witness in education and in middle and high school principalship under G.S. 8C-1, Rule 702. Mr. 
Barbour gave an expert opinion that Petitioner still could function effectively as a teacher, coach, and as a role model in 
middle or high school. 

20. Joseph Miller has been in education for twenty-two years with the New Hanover County schools. He has known 
Petitioner for approximately ten years in his capacities as football coach and athletic director. Mr. Miller was tendered and 
accepted as an expert witness in teaching health and physical education at the high school level under G.S. 8C-1, Rule 702. 
Mr. Miller gave an expert opinion that Petitioner still could function effectively as a teacher in health and physical education 
and could continue to serve as a role model for students enrolled in his health and physical education courses. 

21. Timothy Fitzgerald has been a teacher and assistant football coach at SBHS for the last five years. He served as 
assistant football coach under the supervision of Petitioner for four of his five years at SBHS. Prior to that he was a teacher 
and coach at West Brunswick High School. He served as a teacher and coach in six different schools in Ohio before coming 
to North Carolina. He is certified to teach health and physical education, vocational welding, and history in North Carolina. 
He was tendered and accepted as an expert witness in teaching health and physical education, vocational welding, and history 
under G.S. 8C-1, Rule 702. Mr. Fitzgerald gave an expert opinion that Petitioner still could function effectively as a 
teacher in health and physical education in high school and could continue to serve as a role model for students in his classes. 

22. Petitioner was well regarded in the Brunswick County community prior to the November 1993 allegations. He 



10:2 NORTH CAROLINA REGISTER April 17, 1995 182 



CONTESTED CASE DECISIONS 



continues to have a good reputation as a teacher and coach among those with whom he has worked during his teaching and 
coaching career. 

23. Petitioner's professional effectiveness in the Brunswick County community has been adversely affected by the events 
of November 16, 1993, the subsequent investigation, and the resulting legal and administrative proceedings and press 
coverage. 

24. Public school teachers in North Carolina are required by statute to maintain discipline and to encourage temperance 
and morality among students. N.C. Gen. Stat. Section 115C-307(6) (1994). 

25. Our courts have enumerated various professional functions of teachers including, but not limited to, 

(a) teaching subject matter, 

(b) class discipline, 

(c) interaction with the fellow staff members and administrative superiors, 

(d) interaction with parents and community members, and 

(e) interaction with and being a role model for students. Burrow v^ Board of Education. 61 N.C. App. 619, 
625, 301 S.E.2d 704 (1983) (dismissal upheld where board found teacher no longer effectively could 
perform enumerated professional functions). 

CONCLUSIONS OF LAW 

Based upon the foregoing Findings of Fact, I make the following Conclusions of Law. 

1. The parties are properly before the Office of Administrative Hearings. 

2. Respondent gave Petitioner constitutionally sufficient notice of the charges against him in the January 27, 1994 
FINDING OF REASONABLE CAUSE AND STATEMENT OF CHARGES. Although Respondent indicated its intent to 
proceed against Petitioner's certificate on the basis of its conduct rule, N.C. Admin. Code tit. 16, r. 
6C.0312(a)(8)(November 1994), it also notified Petitioner of the underlying conduct and resultant pending criminal charges 
and that the rule, 6C.0312, governed suspension and revocation of certificates. 

3. Respondent has not defined the term conviction as used in its rules. Our Court has recited, with implicit approval, 
a general rule for defining and applying the term conviction in a driver license revocation case: 

[i]n the restricted or technical legal sense in which it is sometimes used, conviction means the final consummation 
of the prosecution against the accused including the judgment or sentence rendered pursuant to a verdict, confession, 
or plea of guilty. Frequently the term is used to denote the judgment or sentence itself, or to signify both the 
ascertaining of the guilt of accused and judgment thereon by the court. A judgment or sentence is indispensable 
to a conviction in this sense of the term, and the mere ascertainment of guilt by verdict or plea, which satisfies the 
ordinary legal definition of conviction, does not suffice. In construing the term conviction, it has been held that 
the technical meaning ought not to be attributed to it, unless there is something in the context to indicate that it was 
used in such sense. Barbour y_, Scheidt , 246 N.C. 169, 173, 97 S.E.2d 855 (1957) (conviction for speeding with 
prayer for judgment continued not conviction for purpose of driver license revocation because G.S. 20-24(c) then 
required final conviction), citing. 24 C.J.S. Criminal Law, Section 1556, Page 17, in accord, Florence v^ Hiatt , 
101 N.C.App. 539, 400 S.E.2d 118 (1991). 

4. Petitioner's conviction by a district court judge on June 3, 1994 of the criminal offense of assault on a female over 
the age of eighteen is a conviction within the ordinary legal definition of the term and is a conviction within the contemplation 
of N.C. Admin. Code tit. 16, r. 6C. 03 12(a)(3) (November 1994) which does not define or qualify the term so as to require 
its use in the restricted or technical sense. 

5. Respondent produced no evidence of the underlying conduct, from the November 16, 1993 incident, to support its 
charge under N.C. Admin. Code tit. 16, r. 6C.03 12(a)(8) (November 1994), its other illegal, unethical, or lascivious conduct 
rule. Respondent contends that it can proceed against Petitioner's certificate under its conduct rule, without producing 
evidence of his conduct on November 16, 1993, solely by establishing his conviction on June 3, 1994. 

To support this argument, Respondent asserts that Petitioner is estopped to relitigate issues determined in the 
criminal trial. Application of collateral estoppel or res judicata in a subsequent action requires that the initial action result 

183 NORTH CAROLINA REGISTER April 17, 1995 10:2 



CONTESTED CASE DECISIONS 



in a final, appealable judgment. State v^ Lewis , 311, N.C. 727, 319 S.E.2d 145 (1984) (defendant's criminal conviction, 
with final judgment entered, for willful neglect of and refusal to support his minor children estops him from relitigating issue 
of paternity in subsequent civil action); But see. Smith y^ Burden . 31 N.C.App. 145, 228 S.E.2d 662 (1976) (defendant, 
pleading not guilty, found guilty with prayer for judgment continued in criminal action for nonsupport and paternity not 
estopped from litigating issue of paternity in subsequent civil action because there was been no judicial determination (final 
judgment) of paternity). 

It is concluded as a matter of law that Respondent cannot rely solely on proof of Petitioner's conviction with a 
prayer for judgment continued in the criminal action for assault on a female to prove the underlying conduct required to 
sustain its charge of other illegal, unethical, or lascivious conduct in the present administrative action against Petitioner's 
teaching certificate. Id. 

6. Respondent must establish, by the greater weight of the evidence, not only that Petitioner has been convicted of a 
crime as an adult, which it has done, but also that there is a reasonable and adverse relationship between the underlying 
crime and the continuing ability of Petitioner to perform any of his professional functions in an effective manner. N.C. 
Admin. Code tit. 16, r. 6C.03 12(a)(3) (November 1994). 

7. Five expert witnesses testified that Petitioner still could function effectively as a teacher, coach, and role model for 
students. Respondent called no expert witnesses to establish a reasonable and adverse relationship between Petitioner's 
conviction of assault on a female over the age of eighteen and his continuing ability to perform any of his professional 
functions in an effective manner. Considering the evidence thus produced in this contested case hearing, and the illustrative, 
enumerated functions found in Burrows , supra , it is concluded as a matter of law that there is a reasonable and adverse 
relationship between Petitioner's conviction for assault on a female over the age of eighteen and his continuing ability to 
perform his professional functions in an effective manner in the Brunswick County community. 

The preponderance of evidence in this contested case has established that Petitioner likely retains the ability to 
perform his professional functions in an effective manner in some community in North Carolina other than the Brunswick 
County community. 

RECOMMENDED DECISION 

Based upon the foregoing findings of fact and conclusions of law, it is hereby recommended that Respondent 
determine, from the evidence admitted in this contested case hearing, the appropriate discipline, if any, which should be 
applied to Petitioner under the circumstances of this case but that Respondent rescind its intent to permanently revoke 
Petitioner's teaching certificate as not supported by a preponderance of the evidence or by substantial evidence. 

ORDER 

It is hereby ordered that the agency serve a copy of the final decision on the Office of Administrative Hearings, P.O. 
Drawer 27447, Raleigh, N.C. 27611-7447, in accordance with North Carolina General Statute 150B-36(b). 

NOTICE 

The agency making the final decision in this contested case is required to give each party an opportunity to file 
exceptions to this recommended decision and to present written arguments to those in the agency who will make the final 
decision. G.S. 150B-36(a). 

The agency is required by G.S. 150B-36(b) to serve a copy of the final decision on all parties and to furnish a copy 
to the parties' attorney of record and to the Office of Administrative Hearings. 

The agency that will make the final decision in this contested case is the North Carolina State Board of Education. 

This the 31st day of March, 1995. 



Beecher R. Gray 
Administrative Law Judge 



10:2 NORTH CAROLINA REGISTER April 17, 1995 184 



CONTESTED CASE DECISIONS 



STATE OF NORTH CAROLINA 
COUNTY OF HYDE 



IN THE OFFICE OF 

ADMINISTRATIVE HEARINGS 

95 EHR 0140 



HOWARD C. SLACK, 
Petitioner, 



NORTH CAROLINA COASTAL 
RESOURCES COMMISSION and 
NORTH CAROLINA DEPARTMENT OF 
ENVHIONMENT, HEALTH, AND 
NATURAL RESOURCES, 
Respondent. 



ORDER OF DISMISSAL 

FINAL DECISION AS TO 

PETITIONER 



THIS MATTER coming on to be heard by the undersigned Administrative Law Judge upon Respondent's Motion 
to Dismiss; and the undersigned having reviewed the documents submitted by the parties and the law, makes the following: 

FINDINGS OF FACT 

1 . The petition which commenced this contested case was filed with the Office of Administrative Hearings 
on February 8, 1995. 

2. For the reasons stated in the petition, the Petitioner was dissatisfied with a decision by the Respondent to 
grant a CAMA minor development permit to his neighbor to build a pier on what he believed to be his property. 

3. On February 8, 1995, the Petitioner also filed a "Third Party Hearing Request on CAMA Permit Decision" 
with the Coastal Resources Commission as required by G.S. 1 13A-121 . 1(b) in order to request a determination of the 
appropriateness of a contested case hearing. 

4. At the time of the filing of the petition for a contested case hearing with the Office of Administrative 
Hearings, the Third Party Request had not been ruled on by the Coastal Resources Commission. 

5. As stated in the Respondent's Motion to Dismiss and as shown in Exhibit 2 of Petitioner's Response to 
Motion to Dismiss, on February 23, 1995, the Respondent's counsel advised the Petitioner's counsel by letter that the 
Chairman of the Coastal Resources Commission, Mr. Eugene Tomlinson, had denied the Petitioner's hearing request. 

Based upon the foregoing Findings of Fact, the undersigned makes the following: 

CONCLUSIONS OF LAW 

1 . Upon a forecast of evidence provided by the parties, the Petitioner would meet the definition of a "person 
aggrieved" as provided in G.S. 150B-2(6); however, the organic statute, Article 7 of Chapter 113A entitled Coastal Area 
Management Act ("CAMA"), provides a specific exception to the general provisions of the N.C. Administrative Procedure 
Act for dissatisfied third parties. G.S. 1 13A-121. 1(b). 

2. G.S. 1 13A-121 . 1(b) provides that a third party who is dissatisfied with a decision to grant a minor 
development permit may file a petition for a contested case hearing "only if the Coastal Resources Commission determines 
that a hearing is appropriate. " 

3. At the time that the petition was filed on February 8, 1995, the Coastal Resources Commission had not 
made a decision regarding the appropriateness of a hearing as required by G.S. 1 13A-121. 1(b). Therefore, this contested 
case was not ripe for review at the time the petition was filed. 



785 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



CONTESTED CASE DECISIONS 



I 



4. Even if a decision had been made at the time the petition was filed with the Office of Administrative 
Hearings, the organic statute provides that a decision by the Coastal Resources Commission denying the third party request 
for a contested case hearing is a final agency decision and the person aggrieved by such final agency decision is entitled to 
judicial review in superior court pursuant to Article 4 of Chapter 150B of the North Carolina General Statutes. G.S. 113A- 
121.1(b); see also, G.S. 113A-123(a) & (b). 

5. Once the Petitioner receives the written order from the Coastal Resources Commission denying his request 
to commence a contested case, he will have thirty days in which to file a petition for judicial review in superior court. G.S. 
150B-45. Therefore, he maintains an opportunity to redress his grievance. 

6. Based upon Empire Power Co. y^ N.C. Dept. of E.H.N.R. , 337 N.C. 569, 447 S.E.2d 768 (1994), the 
Office of Administrative Hearings does not have subject matter jurisdiction to hear this matter; however, this conclusion of 
law is made without prejudice to the Petitioner should the superior court determine upon judicial review of the denial of 
Petitioner's Third Party Hearing Request that he was entitled to a contested case hearing. 

IT IS THEREFORE ORDERED that the Respondent's Motion to Dismiss this petition based upon a lack of subject 
matter jurisdiction is hereby ALLOWED and this contested case must be and is hereby DISMISSED WITHOUT 
PREJUDICE. This is a final decision pursuant to G.S. 150B-36(c). 

NOTICE 

This final decision is subject to judicial review in the Superior Court Division of the North Carolina General Court 
of Justice in accordance with the provisions of G.S. Chapter 150B, Article 4, which require that an appeal be filed in the 
superior court within thirty (30) days following service upon the person of a written copy of the final decision. 

This the 22nd day of March, 1995. 



Meg Scott Phipps 
k Administrative Law Judge 

1 



I 



10:2 NORTH CAROLINA REGISTER April 17, 1995 186 



NORTH CAROLINA ADMINISTRATIVE CODE CLASSIFICATION SYSTEM 



1 he North Carolina Administrative Code (NCAC) has four major subdivisions of rules. Two of these, titles and 
chapters, are mandatory. The major subdivision of the NCAC is the title. Each major department in the North 
Carolina executive branch of government has been assigned a title number. Titles are further broken down into 
chapters which shall be numerical in order. The other two, subchapters and sections are optional subdivisions 
to be used by agencies when appropriate. 



TITLE/MAJOR DIVISIONS OF THE NORTH CAROLINA ADMINISTRATIVE CODE 
TITLE DEPARTMENT LICENSING BOARDS CHAPTER 



1 


Administration 


Acupuncture 


1 


2 


Agriculture 


Architecture 


2 


3 


Auditor 


Auctioneers 


4 


4 


Commerce 


Barber Examiners 


6 


5 


Correction 


Certified Public Accountant Examiners 


8 


6 


Council of State 


Chiropractic Examiners 


10 


7 


Cultural Resources 


General Contractors 


12 


8 


Elections 


Cosmetic Art Examiners 


14 


9 


Governor 


Dental Examiners 


16 


10 


Human Resources 


Dietetic s/Nutrition 


17 


11 


Insurance 


Electrical Contractors 


18 


12 


Justice 


Electrolysis 


19 


13 


Labor 


Foresters 


20 


14A 


Crime Control & Public Safety 


Geologists 


21 


15A 


Environment, Health, and Natural 


Hearing Aid Dealers and Fitters 


22 




Resources 


Landscape Architects 


26 


16 


Public Education 


Landscape Contractors 


28 


17 


Revenue 


Marital and Family Therapy 


31 


18 


Secretary of State 


Medical Examiners 


32 


19A 


Transportation 


Midwifery Joint Committee 


33 


20 


Treasurer 


Mortuary Science 


34 


♦21 


Occupational Licensing Boards 


Nursing 


36 


22 


Administrative Procedures 


Nursing Home Administrators 


37 


23 


Community Colleges 


Occupational Therapists 


38 


24 


Independent Agencies 


Opticians 


40 


25 


State Personnel 


Optometry 


42 


26 


Administrative Hearings 


Osteopathic Examination & Reg. (Repealed) 


44 






Pharmacy 


46 






Physical Therapy Examiners 


48 






Plumbing, Heating & Fire Sprinkler Contractors 


50 






Podiatry Examiners 


52 






Professional Counselors 


53 






Practicing Psychologists 


54 






Professional Engineers & Land Surveyors 


56 






Real Estate Appraisal Board 


57 






Real Estate Commission 


58 






Refrigeration Examiners 


60 






Sanitarian Examiners 


62 






Social Work Certification 


63 






Speech & Language Pathologists & Audiologists 


64 






Therapeutic Recreation Certification 


65 






Veterinary Medical Board 


66 



Note: Title 21 contains the chapters of the various occupational licensing boards. 



757 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



CUMULATIVE INDEX 



Agency/Rule Citation 



Proposed in 
Register 



Proposed 

Effective 

Date 



Fiscal Note 



State Local 



Effective 
Date 



Other Information 



ACUPUNCTURE LICENSING BOARD 



21 NCAC 01 


.0101 




10:02 NCR 


150 


07/01/95 








.0401 - 


.0402 


10:02 NCR 


150 


07/01/95 






CORRECTION 
















5 NCAC 05 


.0001 




10:01 NCR 


12 


07/01/95 






CULTURAL RESOURCES 












7 NCAC 02F 


.0002 




10:01 NCR 


12 


07/01/95 






ENVIRONMENT 


, HEALTH, AND NATURAL RESOURCES 






15A NCAC 02B 


.0101 
.0104 
.0202 
.0211 
.0301 




10:01 NCR 
10:01 NCR 
10:01 NCR 
10:01 NCR 
10:01 NCR 


13 
13 
13 
13 
13 








02D 


.0520 




10.01 NCR 


13 


07/01/95 


X 


X 




.0531 




10:01 NCR 


13 


07/01/95 


X 


X 




.0902 




10:01 NCR 


13 


07/01/95 


X 


X 




.0909 




10:01 NCR 


13 


07/01/95 


X 


X 




.0952 




10:01 NCR 


13 


07/01/95 


X 


X 




.1402 




10:01 NCR 


13 


07/01/95 


X 


X 




.1406 




10:01 NCR 


13 


07/01/95 


X 


X 




.1409 




10:01 NCR 


13 


07/01/95 


X 


X 




.1701 - 


.1702 


10:01 NCR 


13 


07/01/95 


X 


X 




.1801 - 


.1803 


10:01 NCR 


13 


07/01/95 


X 


X 


NPDES Permit 






10:02 NCR 


56 








04B 


.0028 




10:02 NCR 


149 


07/01/95 






10B 


.0202- 


.0203 


10:01 NCR 


26 


07/01/95 








.0214 




10:01 NCR 


26 


07/01/95 






10D 


.0002- 


.0003 


10:01 NCR 


26 


07/01/95 






10F 


.0317 




10:01 NCR 


26 


07/01/95 






Wildlife Proclamation/Stripec 


Bass 


10:02 NCR 


57 


04/10/95 






FINAL DECISION LETTERS 












Voting Rights Act 






10:01 NCR 


02 









Correction to Notice 
Correction to Notice 
Correction to Notice 
Correction to Notice 
Correction to Notice 



GOVERNOR'S EXECUTIVE ORDERS 

Number 72 10:01 NCR 01 

Number 73 10:02 NCR 54 

Number 74 10:02 NCR 54 



03/06/95 
03/15/95 
03/27/95 



HUMAN RESOURCES 

10 NCAC 03H 



.0108 - 


.0109 


10:02 NCR 


58 


09/01/95 


.0206- 


.0220 


10:02 NCR 


58 


09/01/95 


.0306- 


.0318 


10:02 NCR 


58 


09/01/95 


.0407- 


.0409 


10:02 NCR 


58 


09/01/95 


.0505 - 


.0507 


10:02 NCR 


58 


09/01/95 


.0510 - 


.0517 


10:02 NCR 


58 


09/01/95 


.0605 - 


.0609 


10:02 NCR 


58 


09/01/95 


.0705 - 


.0712 


10:02 NCR 


58 


09/01/95 


.0810 - 


.0812 


10:02 NCR 


58 


09/01/95 


.0903 - 


.0911 


10:02 NCR 


58 


09/01/95 


.1003 - 


.1008 


10:02 NCR 


58 


09/01/95 


.1105 - 


.1109 


10:02 NCR 


58 


09/01/95 


.1130- 


.1136 


10:02 NCR 


58 


09/01/95 


.1150- 


.1163 


10:02 NCR 


58 


09/01/95 


.1204- 


.1208 


10:02 NCR 


58 


09/01/95 


.1210 




10:02 NCR 


58 


09/01/95 


.1306- 


.1308 


10:02 NCR 


58 


09/01/95 


.1405 - 


.1406 


10:02 NCR 


58 


09/01/95 



10:2 



NORTH CAROLINA REGISTER 



April 17, 1995 



188 



CUMULATIVE INDEX 







Proposed 






Effective 


Other Information 




Proposed in 


Fiscal note 


Agency /Rule Citation 


Register 


Effective 
Date 


State 


Local 


Date 









.1408 - 


.1410 


10:02 NCR 


58 


09/01/95 




.1501 - 


.1503 


10:02 NCR 


58 


09/01/95 




.1612 - 


.1613 


10:02 NCR 


58 


09/01/95 




.1703 - 


.1704 


10:02 NCR 


58 


09/01/95 




.1804 - 


.1807 


10:02 NCR 


58 


09/01/95 




.2001 




10:02 NCR 


58 


09/01/95 




.2101 - 


.2110 


10:02 NCR 


58 


09/01/95 




.2201 - 


.2212 


10:02 NCR 


58 


09/01/95 




.2301 - 


.2308 


10:02 NCR 


58 


09/01/95 




.2401 - 


.2402 


10:02 NCR 


58 


09/01/95 




.2501 - 


.2506 


10:02 NCR 


58 


09/01/95 




.2601 - 


.2607 


10:02 NCR 


58 


09/01/95 




.2701 




10:02 NCR 


58 


09/01/95 




.2801 - 


.2802 


10:02 NCR 


58 


09/01/95 




.2901 - 


.2902 


10:02 NCR 


58 


09/01/95 




.3001 - 


.3005 


10:02 NCR 


58 


09/01/95 




.3011 - 


.3016 


10:02 NCR 


58 


09/01/95 




.3021 - 


.3032 


10:02 NCR 


58 


09/01/95 




.3101 - 


.3104 


10:02 NCR 


58 


09/01/95 




.3201 - 


.3202 


10:02 NCR 


58 


09/01/95 




.3301 - 


.3302 


10:02 NCR 


58 


09/01/95 




.3401 - 


.3404 


10:02 NCR 


58 


09/01/95 


18J 


.0803 




10:02 NCR 


118 


07/01/95 


26B 


.0124 




10:02 NCR 


118 


07/01/95 


26H 


.0213 




10:02 NCR 


118 


07/01/95 


JUSTICE 












12 NCAC 09A 


.0204 




10:02 NCR 


122 


08/01/95 


09B 


.0113 




10:02 NCR 


122 


08/01/95 




.0201 - 


.0202 


10:02 NCR 


122 


08/01/95 




.0205 - 


.0206 


10:02 NCR 


122 


08/01/95 




.0210 




10:02 NCR 


122 


08/01/95 




.0212 - 


.0214 


10:02 NCR 


122 


08/01/95 




.0226 - 


.0228 


10:02 NCR 


122 


08/01/95 




.0232 - 


.0233 


10:02 NCR 


122 


08/01/95 


09C 


.0401 




10:02 NCR 


122 


08/01/95 




.0601 




10:02 NCR 


122 


08/01/95 


09D 


.0102 




10:02 NCR 


122 


08/01/95 




.0104- 


.0106 


10:02 NCR 


122 


08/01/95 


LABOR 












13 NCAC 






10:01 NCR 


10 


01/01/96 








10:01 NCR 


12 


01/01/96 








10:02 NCR 


149 


10/01/95 








10:02 NCR 


149 


01/01/96 








10:02 NCR 


149 


01/01/96 








10:02 NCR 


149 


02/01/96 


12 


.0101 




10:02 NCR 


142 


08/01/95 




.0303 - 


.0315 


10:02 NCR 


142 


08/01/95 




.0501 - 


.0502 


10:02 NCR 


142 


08/01/95 




.0803 - 


.0808 


10:02 NCR 


142 


08/01/95 


LIST OF RULES CODIFIED 














10:02 NCR 


167 




MEDICAL EXAMINERS 








21 NCAC 32H 


.0102 




10:02 NCR 


151 


07/01/96 




.0201 




10:02 NCR 


151 


07/01/96 




.0203 




10:02 NCR 


151 


07/01/96 




.0408 




10:02 NCR 


151 


07/01/96 




.0506 




10:02 NCR 


151 


07/01/96 




.0601 




10:02 NCR 


151 


07/01/95 




.0602 




10:02 NCR 


151 


07/01/96 




.0801 




10:02 NCR 


151 


07/01/96 



Notice on Subject Matter 
Notice on Subject Matter 
Notice on Subject Matter 
Notice on Subject Matter 
Notice on Subject Matter 
Notice on Subject Matter 



Rules Filed 03/95 



189 



NORTH CAROLINA REGISTER 



April 17, 1995 



10:2 



CUMULATIVE INDEX 



Agency/Rule Citation 



Proposed in 
Register 



Proposed 

Effective 

Date 



Fiscal Note 



State Local 



Effective 
Date 



Other Information 



32H .1001 

321 .0003 - .0004 



10:02 NCR 
10:02 NCR 



151 
151 



07/01/96 
07/01/95 



PLUMBING, HEATING & FIRE SPRINKLER CONTRACTORS 

21 NCAC 50 .0402 10:01 NCR 39 09/01/95 

.0505 10:01 NCR 39 09/01/95 

PROFESSIONAL COUNSELORS 



21 NCAC 


53 .0204 - 


.0211 


10:01 NCR 


40 


07/01/95 




.0301 




10:01 NCR 


40 


07/01/95 




.0305 - 


.0310 


10:01 NCR 


40 


07/01/95 




.0403 - 


.0405 


10:01 NCR 


40 


07/01/95 




.0601 - 


.0604 


10:01 NCR 


40 


07/01/95 


REAL ESTATE COMMISSION 








21 NCAC 


58A .0110 




10:02 NCR 


157 


07/01/95 




.0504- 


.0506 


10:02 NCR 


157 


07/01/95 




.1703 




10:02 NCR 


157 


07/01/95 




.1707 - 


.1708 


10:02 NCR 


157 


07/01/95 




.1710- 


.1711 


10:02 NCR 


157 


07/01/95 




58E .0103 




10:02 NCR 


157 


07/01/95 




.0203 - 


.0204 


10:02 NCR 


157 


07/01/95 




.0303 - 


.0305 


10:02 NCR 


157 


07/01/95 




.0406- 


.0407 


10:02 NCR 


157 


07/01/95 




.0506 




10:02 NCR 


157 


07/01/95 




.0515 




10:02 NCR 


157 


07/01/95 


REVENUE 












Tax Review Board 




10:01 NCR 


03 





10.2 



NORTH CAROLINA REGISTER 



April 17, 1995 



190 



I 



♦ 



< 



BARCLAYS OFFICIAL 
NORTH CAROLINA ADMINISTRATIVE CODE 

The full Barclays Official North Carolina Administrative Code consists of 22 volumes, totaling in excess of 
10,000 pages. It is supplemented monthly with replacement pages. A one year subscription to the full 
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Individual volumes may also be purchased with supplement service. Renewal subscriptions for supplements 
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1 - 6 Education 

1-6 Revenue 

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(repealed) Administrative Procedures 

1-3 Community Colleges 

1-5 Independent Agencies 

1 State Personnel 

1-4 Administrative Hearings 

Binders (1 binder per item ordered) 
Shipping & Handling (per item ordered) 
(entire code) 

< 
(North Carolina sales 


$90.00 




17 


$75.00 




18 


$30.00 




18 


$75.00 




18 


$60.00 




19 


$30.00 




19 


$90.00 




19 


$45.00 




20 


$75.00 




20 


$75.00 




21 

N/A 


$60.00 
N/A 
$10.00 




22 




22 


$10.00 




22 


$60.00 




22 


$10.00 






$16.00 






i $4.50 
$85.00 

Subtotal 

tax 6%) 

Total 





















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